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Validation of the Japanese Society for Surgery of the Hand version of the Carpal Tunnel Syndrome Instrument.

ABSTRACT: 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.

SUBMITTER: Imaeda T

PROVIDER: S-EPMC2778629 | biostudies-other | 2007 Jan

REPOSITORIES: biostudies-other

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Project description: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 α = 0.825). However, the SSS has three dimensions, which are all highly internally consistent: "daytime symptoms" (Cronbach's α = 0.805), "nighttime symptoms" (Cronbach's α = 0.835), and "operational capacity" (Cronbach's α = 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 ΔFSS and ΔSSS 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.

Project description:BACKGROUND: The Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire is a region-specific, self-administered questionnaire, which consists of a disability/symptom (QuickDASH-DS) scale, and the same two optional modules, the work (DASH-W) and the sport/music (DASH-SM) modules, as the DASH. After the Japanese version of DASH (DASH-JSSH) was cross-culturally adapted and developed, we made the Japanese version of QuickDASH (QuickDASH-JSSH) by extracting 11 out of 30 items of the DASH-JSSH regarding disability/symptoms. The purpose of this study was to test the reliability, validity, and responsiveness of QuickDASH-JSSH. METHODS: A series of 72 patients with upper extremity disorders completed the QuickDASH-JSSH, the 36-Item Short-Form Health Survey (SF-36), and the Visual Analog Scale (VAS) for pain. Thirty-eight of the patients were reassessed for test-retest reliability 1 or 2 weeks later. Reliability was investigated by the reproducibility and internal consistency. To analyze the validity, a principal component analysis and the correlation coefficients between the QuickDASH-JSSH and the SF-36 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 of the 17 patients with carpal tunnel syndrome. RESULTS: Cronbach's alpha coefficient in the QuickDASH-DS was 0.88. The intraclass correlation coefficient (ICC) for the same was 0.82. The unidimensionality of the QuickDASH-DS was confirmed. The correlation coefficients between the QuickDASH-DS and the DASH-DS, DASH-W, or the DASH-SM were 0.92, 0.81, or 0.76, respectively. The correlation coefficients between the QuickDASH-DS score and the subscales of the SF-36 ranged from -0.29 to -0.73. The correlation coefficient between the QuickDASH-DS score and the VAS for pain was 0.52. The SRM/effect size of QuickDASH-DS was -0.54/-0.37, which indicated moderate sensitivity. CONCLUSION: The Japanese version of QuickDASH has equivalent evaluation capacities to the original QuickDASH.

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Validation of the Japanese Society for Surgery of the Hand version of the Carpal Tunnel Syndrome Instrument.

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