Clinical Utility of the 6-Item CTS, Boston-CTS, and Hand-Diagram for Carpal Tunnel Syndrome

Background: Self-reported measures are often used in research and clinical practice to diagnose carpal tunnel syndrome (CTS) and guide therapeutic choices. We aimed to assess the clinical utility of the Norwegian versions of two self-reported outcome measures for symptom severity assessment, the 6-i...

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Main Authors: Daniel Gregor Schulze, Kristian Bernhard Nilsen, Rikke Munk Killingmo, John Anker Zwart, Margreth Grotle
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-07-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2021.683807/full
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spelling doaj-98d65eca2eff4c689ba2a0f3a06026812021-07-27T09:06:51ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-07-011210.3389/fneur.2021.683807683807Clinical Utility of the 6-Item CTS, Boston-CTS, and Hand-Diagram for Carpal Tunnel SyndromeDaniel Gregor Schulze0Daniel Gregor Schulze1Daniel Gregor Schulze2Kristian Bernhard Nilsen3Kristian Bernhard Nilsen4Rikke Munk Killingmo5John Anker Zwart6John Anker Zwart7Margreth Grotle8Margreth Grotle9Department of Neurology, Oslo University Hospital and University of Oslo, Oslo, NorwayInstitute of Clinical Medicine, University of Oslo, Oslo, NorwayDepartment of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, NorwayDepartment of Neurology, Oslo University Hospital and University of Oslo, Oslo, NorwayDepartment of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, NorwayOslo Metropolitan University, Oslo, NorwayInstitute of Clinical Medicine, University of Oslo, Oslo, NorwayDepartment of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, NorwayDepartment of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, NorwayOslo Metropolitan University, Oslo, NorwayBackground: Self-reported measures are often used in research and clinical practice to diagnose carpal tunnel syndrome (CTS) and guide therapeutic choices. We aimed to assess the clinical utility of the Norwegian versions of two self-reported outcome measures for symptom severity assessment, the 6-item CTS (CTS-6), and Boston-CTS (BCTQ), and of one diagnostic measure, the hand-diagram, by evaluating measurement properties including discriminative ability for severity assessment (CTS-6, BCTQ), and diagnosis of CTS (hand-diagram).Methods: We performed forward and backward translation and cultural adaptation of the Norwegian CTS-6 and BCTQ. Following COSMIN guidelines, we investigated internal consistency, reliability, construct validity, and discriminative ability for distinguishing between severity levels of CTS in patients with confirmed CTS for the CTS-6 and BCTQ and reliability and discriminative ability for diagnosing CTS for the hand-diagram.Results: Two hundred and fifty-one patients referred for diagnostic work-up for CTS with nerve conduction studies (NCS) participated. The CTS-6 and BCTQ had acceptable internal consistency (Crohnbach's α = 0.82 and 0.86, respectively), reliability (ICC = 0.86 and 0.90; SEM = 0.24 and 0.20; SDC95% = 0.68 and 0.55, respectively), construct validity (all eight pre-defined hypotheses confirmed) and discriminative ability to distinguish between severity levels of CTS [Area under the curve (AUC) = 0.75, 95% CI 0.64–0.85]. The hand-diagram had acceptable reliability (Cohen's kappa = 0.69) and discriminative ability to diagnose CTS (sensitivity = 0.72, specificity = 0.90).Conclusion: Our findings support the clinical utility of the CTS-6 and BCTQ for symptom severity assessment and of the hand-diagram for diagnostic screening.https://www.frontiersin.org/articles/10.3389/fneur.2021.683807/fullclinical utilityNorwegian6-item CTShand-diagramcarpal tunnel syndromeBoston CTS questionnaire
collection DOAJ
language English
format Article
sources DOAJ
author Daniel Gregor Schulze
Daniel Gregor Schulze
Daniel Gregor Schulze
Kristian Bernhard Nilsen
Kristian Bernhard Nilsen
Rikke Munk Killingmo
John Anker Zwart
John Anker Zwart
Margreth Grotle
Margreth Grotle
spellingShingle Daniel Gregor Schulze
Daniel Gregor Schulze
Daniel Gregor Schulze
Kristian Bernhard Nilsen
Kristian Bernhard Nilsen
Rikke Munk Killingmo
John Anker Zwart
John Anker Zwart
Margreth Grotle
Margreth Grotle
Clinical Utility of the 6-Item CTS, Boston-CTS, and Hand-Diagram for Carpal Tunnel Syndrome
Frontiers in Neurology
clinical utility
Norwegian
6-item CTS
hand-diagram
carpal tunnel syndrome
Boston CTS questionnaire
author_facet Daniel Gregor Schulze
Daniel Gregor Schulze
Daniel Gregor Schulze
Kristian Bernhard Nilsen
Kristian Bernhard Nilsen
Rikke Munk Killingmo
John Anker Zwart
John Anker Zwart
Margreth Grotle
Margreth Grotle
author_sort Daniel Gregor Schulze
title Clinical Utility of the 6-Item CTS, Boston-CTS, and Hand-Diagram for Carpal Tunnel Syndrome
title_short Clinical Utility of the 6-Item CTS, Boston-CTS, and Hand-Diagram for Carpal Tunnel Syndrome
title_full Clinical Utility of the 6-Item CTS, Boston-CTS, and Hand-Diagram for Carpal Tunnel Syndrome
title_fullStr Clinical Utility of the 6-Item CTS, Boston-CTS, and Hand-Diagram for Carpal Tunnel Syndrome
title_full_unstemmed Clinical Utility of the 6-Item CTS, Boston-CTS, and Hand-Diagram for Carpal Tunnel Syndrome
title_sort clinical utility of the 6-item cts, boston-cts, and hand-diagram for carpal tunnel syndrome
publisher Frontiers Media S.A.
series Frontiers in Neurology
issn 1664-2295
publishDate 2021-07-01
description Background: Self-reported measures are often used in research and clinical practice to diagnose carpal tunnel syndrome (CTS) and guide therapeutic choices. We aimed to assess the clinical utility of the Norwegian versions of two self-reported outcome measures for symptom severity assessment, the 6-item CTS (CTS-6), and Boston-CTS (BCTQ), and of one diagnostic measure, the hand-diagram, by evaluating measurement properties including discriminative ability for severity assessment (CTS-6, BCTQ), and diagnosis of CTS (hand-diagram).Methods: We performed forward and backward translation and cultural adaptation of the Norwegian CTS-6 and BCTQ. Following COSMIN guidelines, we investigated internal consistency, reliability, construct validity, and discriminative ability for distinguishing between severity levels of CTS in patients with confirmed CTS for the CTS-6 and BCTQ and reliability and discriminative ability for diagnosing CTS for the hand-diagram.Results: Two hundred and fifty-one patients referred for diagnostic work-up for CTS with nerve conduction studies (NCS) participated. The CTS-6 and BCTQ had acceptable internal consistency (Crohnbach's α = 0.82 and 0.86, respectively), reliability (ICC = 0.86 and 0.90; SEM = 0.24 and 0.20; SDC95% = 0.68 and 0.55, respectively), construct validity (all eight pre-defined hypotheses confirmed) and discriminative ability to distinguish between severity levels of CTS [Area under the curve (AUC) = 0.75, 95% CI 0.64–0.85]. The hand-diagram had acceptable reliability (Cohen's kappa = 0.69) and discriminative ability to diagnose CTS (sensitivity = 0.72, specificity = 0.90).Conclusion: Our findings support the clinical utility of the CTS-6 and BCTQ for symptom severity assessment and of the hand-diagram for diagnostic screening.
topic clinical utility
Norwegian
6-item CTS
hand-diagram
carpal tunnel syndrome
Boston CTS questionnaire
url https://www.frontiersin.org/articles/10.3389/fneur.2021.683807/full
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