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Patient Reported Outcome Measures Tools in Carpal Tunnel
Syndrome
Patient Empowerment—i.e., involving CTS patients in the decision-making regard-
ing their condition and its management—paved the way for further research, ini-
tially to identify tools to assess the patient’s symptoms and its severity and later on
to assess its responsiveness to change. This included validity and reproducibility of
these scales. Results from follow-up studies showed that these scales are consider-
ably more responsive to clinical improvement than traditional measures [ 24 ].
Furthermore, patient reported outcome measures were also found able to predict
response to conservative treatment and thereby predict probability of undergoing
surgery [ 25 ]. These data highlighted the important role of patient reported outcome
measure assessment in CTS as a potential bridge between research and good prac-
tice in CTS patients.
Reviewing the literature revealed several patient-reported-based questionnaires
for CTS. These can be categorized into three main groups:
- Questionnaires to screen and assess for the possibility of having CTS, i.e., diag-
nosis. These can be either Web-based or in paper format. - Questionnaires to assess for the severity of CTS symptoms.
- Questionnaires to assess for the patients’ functional ability as well as the impact
of the condition on their work, life, and leisure.
These PROMs questionnaires can be also classifi ed into (Table 13.1 ) [ 29 , 30 ]:
generic health status, and condition- or population-specifi c measures. (There is a
third category, called “preference-based measures,” which is also broad in content,
however, it also provides utilities or values regarding health for use in, for example,
cost-utility analyses of interventions.) Generic instruments encompass items rele-
vant to the widest range of patient conditions/general population. Condition-specifi c
instruments tend to be more focused on a particular disease or health condition (e.g.,
rheumatoid arthritis or CTS), a patient population (e.g., older people), a specifi c
problem or symptom (e.g., pain), or a described function (e.g., activities of daily
living). For any given area of health in standard clinical practice, condition-specifi c
instruments usually have greater clinical appeal due to the inclusion of content spe-
cifi c to a particular condition, and the likelihood of increased responsiveness to
interventions. Examples of these specifi c tools for assessment of CTS patients
include the following.
The Boston Carpal Tunnel Questionnaire (BCTQ)
The questionnaire ( BCTQ ), developed in 1993 [ 31 ], is a patient-based outcome
measure questionnaire that has been developed specifi cally for CTS patients.
Though it is well known for its current name (BCTQ), it can be also referred to as
Y. El Miedany