COSMIN database

Critical analysis of outcome measures used in the assessment of carpal tunnel syndrome

Sambandam, S. N., Priyanka, P., Gul, A., and Ilango, B.
Clinicians and researchers are confounded by the various outcome measures used for the assessment of carpal tunnel syndrome (CTS). In this study, we critically analysed the conceptual framework, validity, reliability, responsiveness and appropriateness of some of the commonly used CTS outcome measures. Initially, we conducted an extensive literature search to identify all of the outcome measures used in the assessment of CTS patients, which revealed six different carpal tunnel outcome measures [Boston Carpal Tunnel Questionnaire (BCTQ), Michigan Hand Outcome Questionnaire (MHQ), Disability of Arm, Shoulder and Hand (DASH), Patient Evaluation Measure (PEM), clinical rating scale (Historical-Objective (Hi-Ob) scale) and Upper Extremity Functional Scale (UEFS)]. We analysed the construction framework, development process, validation process, reliability, internal consistency (IC), responsiveness and limitations of each of these outcome measures. Our analysis reveals that BCTQ, MHQ and PEM have comprehensive frameworks, good validity, reliability and responsiveness both in the hands of the developers, as well as independent researchers. The UEFS and Hi-Ob scale need validation and reliability testing by independent researchers. Region-specific measures like DASH have good frameworks and, hence, a potential role in the assessment of CTS but they require more validation in exclusive carpal tunnel patients.
<Go to ISI>://WOS:000257205400013
International Orthopaedics
Publication year:
Symptom status:
Physical state
Functional status:
Physical functioning
Adults (18-65)
Children (0-18)
Seniors (65+)
Diseases of and symptoms related to the nervous system
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
6 - Clinical rating scales
7 - Observations
BCTQ - Boston Carpal Tunnel Questionnaire   
DASH - Disabilities of the Arm, Shoulder and Hand (versions: DASH Modified)   
Hi-Ob - Historical-Objective scale
MHQ - Michigan Hand outcomes Questionnaire   
PEM - Patient Evaluation Measure
UEFS - Upper Extremity Functional Scale