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Validation of the Dutch Version of the Boston Carpal Tunnel Questionnaire.

ABSTRACT: The Boston Carpal Tunnel Questionnaire (BCTQ) is a scale that has been developed specifically for carpal tunnel syndrome (CTS). It consists of the Functional Status Scale (FSS) and the Symptom Severity Scale (SSS). It is the most widely used patient reported outcome measure in CTS and has been validated in many languages. Although already widely used, psychometric properties of the Dutch version of the BCTQ are yet unknown. The aim of this study was to assess the validity, reliability, responsiveness, and acceptability of the Dutch version. Moreover, this paper focuses the longitudinal validity (the use after an intervention) of the BCTQ, which has not been investigated before. A total of 180 patients completed the BCTQ in addition to a six-point Likert scale for perceived improvement, before and about 6-8 months after carpal tunnel release (CTR). Principal factor analysis revealed that the FSS is unidimensional, consisting of a single latent factor ("functionality") and has a high internal consistency (Cronbach's ? = 0.825). However, the SSS has three dimensions, which are all highly internally consistent: "daytime symptoms" (Cronbach's ? = 0.805), "nighttime symptoms" (Cronbach's ? = 0.835), and "operational capacity" (Cronbach's ? = 0.723). Post-treatment, the FSS still consisted of one factor, but the SSS changed in dimensionality, as it had only two factors left post-treatment. The ?FSS and ?SSS had good correlation with the six-point Likert scale for perceived improvement (r = 0.524; p < 0.01 and r = 0.574; p < 0.01, respectively), a moderate correlation between FSS and pinch grip (r = 0.259; p < 0.01) was found, and a weak correlation between SSS and pinch grip (r = 0.231; p < 0.01) was found. Standard Response Mean for FSS and SSS was 0.76 and 1.49, respectively. Effect size was 0.92 and 1.96, respectively, both indicating a good responsiveness. Response rate was high (82-84%). We concluded that the Dutch version of the BCTQ has a proper reliability, validity, responsiveness, and acceptability to assess the symptom severity and functional disabilities of CTS patients. Because of multidimensionality, we would recommend to create sum scores of the four different dimensions instead of two. Caution is required when interpreting the results postoperatively, due to the insufficient longitudinal validity of the SSS.

SUBMITTER: De Kleermaeker FGCM

PROVIDER: S-EPMC6854027 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Validation of the Dutch Version of the Boston Carpal Tunnel Questionnaire.

De Kleermaeker Floriaan G C M FGCM Levels Mark M Verhagen Wim I M WIM Meulstee Jan J

Frontiers in neurology 20191107

The Boston Carpal Tunnel Questionnaire (BCTQ) is a scale that has been developed specifically for carpal tunnel syndrome (CTS). It consists of the Functional Status Scale (FSS) and the Symptom Severity Scale (SSS). It is the most widely used patient reported outcome measure in CTS and has been validated in many languages. Although already widely used, psychometric properties of the Dutch version of the BCTQ are yet unknown. The aim of this study was to assess the validity, reliability, responsiv ...[more]

PMID: 31787920

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Project description:IntroductionThe Boston Carpal Tunnel Questionnaire (BCTQ) is a widely recommended patient-reported outcome measure to evaluate symptoms and functions in carpal tunnel syndrome (CTS) patients. We aimed to evaluate the translation and cross-cultural adaptation of the Thai version of the BCTQ (Thai BCTQ) and to investigate the psychometric properties including internal consistency, test-retest reliability, construct validity and responsiveness.MethodsThe Thai BCTQ was field tested with 15 healthy volunteers and 15 CTS patients to evaluate the item-objective congruence of each item. Following that, one hundred and twenty-four CTS patients were included for psychometric evaluation in this study. Internal consistency was assessed using Cronbach's alpha. Test-retest reliability was examined using the intraclass correlation coefficient (ICC). To evaluate construct validity, Spearman's rank correlation of the symptom severity scale (Thai BCTQ -S), the functional status scale (Thai BCTQ -F) and the subscales of the Thai MHQ were analyzed. Responsiveness was determined using the standardized response mean (SRM).ResultsMinor modification of the Thai version was made to better explain the term "tingling". The Thai BCTQ-S, Thai BCTQ-F and Thai BCTQ demonstrated adequate Cronbach's alpha values (0.91-0.94) and good test-retest reliability (ICC=0.89-0.98). Regarding related dimensions, a strong correlation (r=0.67, P<0.008) was found between the Thai BCTQ-F and the Function subscale of Thai MHQ as well as between Thai BCTQ-F and the Activities of Daily Living subscale of the Thai MHQ (r=0.75, P<0.008). In unrelated dimensions, there was a relatively weak correlation between the Thai BCTQ-S and the Aesthetics subscale of the Thai MHQ (r=0.32, P=0.0116). The SRM of the Thai BCTQ was 1.46, indicating large responsiveness.DiscussionThe Thai BCTQ has adequate internal consistency in both the symptom and function scales as well as good construct validity and test-retest reliability indicating it is suitable for evaluating Thai CTS patients. This tool also has a high ability to detect clinically significant changes in symptoms and function over time after receiving conservative or surgical treatment.

Project description:BackgroundThe Boston Carpal Tunnel Questionnaire (BCTQ) and its shorter version, the Six-Item Carpal Tunnel Symptoms Scale (CTS-6), are widely used for assessing function and/or symptoms in patients with carpal tunnel syndrome. This study examined the structural validity of the BCTQ and CTS-6 among patients who had undergone surgery for treatment of carpal tunnel syndrome.MethodsThe data for this cross-sectional analysis were obtained from 217 adult patients who had undergone carpal tunnel release surgery 1 year earlier. All patients completed the CTS-6, Symptom Severity Scale (SSS) and Functional Status Scale (FSS) of the BCTQ at 12 months after surgery. The Rasch Measurement Theory (RMT) was applied to investigate the unidimensionality, residual correlation, differential item functioning, scale coverage/targeting, and person separation of the CTS-6, SSS and FSS of the BCTQ.ResultsThe FSS showed unidimensionality and good scale and item fit. All items showed ordered response category thresholds. Eight of the FSS items displayed differential item functioning favoring age or gender. The multidimensional structure of the CTS-6 was absorbed by creating a testlet for frequency of symptoms or testlets for pain and numbness. The testlets supported unidimensionality in the BCTQ SSS. One item in the CTS-6 and two items in the BCTQ SSS showed differential item functioning favoring age or gender. Four items in the BCTQ SSS and two items in the CTS-6 exhibited disordered response category thresholds. Merging of the relevant response categories led to ordered response category thresholds. The person separation indices were 0.73, 0.86 and 0.77 for the CTS-6, BCTQ SSS and FSS, respectively.ConclusionsBased on the RMT analysis, the CTS-6 has superior psychometric properties compared to the BCTQ SSS in surgically treated patients. The CTS-6 might be more accurate when separated into item sets measuring pain or numbness. The FSS of the BCTQ has acceptable construct validity, although gender differences at some ages were observed in responses.

Project description:BACKGROUND: The Carpal Tunnel Syndrome Instrument (CTSI) is a disease-specific, self-administered questionnaire that consists of a symptom severity scale (SS) and a functional status scale (FS). The CTSI was cross-culturally adapted and developed by the Impairment Evaluation Committee, Japanese Society for Surgery of the Hand (JSSH). The purpose of this study was to test the reliability, validity, and responsiveness of the Japanese version of the CTSI (CTSI-JSSH). METHODS: A consecutive series of 87 patients with carpal tunnel syndrome completed the CTSI-JSSH, the JSSH version of the Disability of the Arm, Shoulder, and Hand questionnaire (DASH-JSSH), and the 36-Item Short-Form Health Survey (SF-36). Seventy-two of the patients were reassessed for test-retest reliability 1 or 2 weeks later. Reliability was investigated by the reproducibility and the internal consistency. To analyze the validity, a factor analysis (principal axis factoring) of the CTSI-JSSH and the correlation coefficients between the CTSI-JSSH and DASH-JSSH were obtained. The responsiveness was examined by calculating the standardized response mean (SRM; mean change/SD) and effect size (mean change/SD of baseline value) after carpal tunnel release in 42 patients. RESULTS: Cronbach's alpha coefficients for the CTSI-JSSH-SS and the CTSI-JSSH-FS were 0.84 and 0.90, respectively, and the intraclass correlation coefficients were 0.82 and 0.83, respectively. The unidimensionality of the CTSI-JSSH-SS was barely confirmed; the unidimensionality of the CTSI-JSSH-FS was confirmed. The correlation coefficients between the CTSI-JSSH-FS and the CTSI-JSSH-SS or DASH-JSSH were 0.58 and 0.80, respectively. The correlation coefficient between the CTSI-JSSH-SS and DASH-JSSH was 0.54. The correlation coefficients between the subscales of SF-36 and the CTSI-JSSH-SS or the CTSI-JSSH-FS ranged from -0.23 to -0.66 and from -0.19 to -0.63, respectively. The SRMs/effect sizes of the CTSI-JSSH-SS and the CTSI-JSSH-FS were -0.85/-0.99 and -0.70/-0.61, which indicated that they were more than moderately sensitive. CONCLUSIONS: The CTSI-JSSH has sufficient reliability, validity, and responsiveness to assess the health status in carpal tunnel syndrome.

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Validation of the Dutch Version of the Boston Carpal Tunnel Questionnaire.

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Validation of the Dutch Version of the Boston Carpal Tunnel Questionnaire.

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