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Wang AMQ, Retrouvey H, Krahn M, McCabe SJ, Baltzer HL. Direct and indirect utilities of patients with mild to moderate versus severe carpal tunnel syndrome. J Hand Surg Eur Vol 2020; 45:832-837. [PMID: 32380923 DOI: 10.1177/1753193420922791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Health utility is a quantitative global measure of patients' health status. This retrospective cohort study aimed to compare health utilities of patients with mild to moderate versus severe carpal tunnel syndrome and determine inter-instrumental agreement. Health utilities of 29 patients with varying severity of carpal tunnel syndrome were measured indirectly by Short-Form Sixth Dimension and EuroQol 5D questionnaire and directly by Chained Standard Gamble and a visual analogue scale. Health utility was 0.69 for Short-Form Sixth Dimension, 0.78 for EuroQol 5D Questionnaire, 0.98 for Chained Standard Gamble, and 0.76 for the visual analogue scale. There was a significant inter-instrumental agreement between three of the instruments, but not the Chained Standard Gamble. The difference in health utilities between patients with mild or moderate versus severe carpal tunnel syndrome was significant only for the EuroQol 5D questionnaire. We conclude based on our results that there are no clear indications on how health utilities can be integrated into decision analysis models and economic evaluation regarding carpal tunnel syndrome of various severities.Level of evidence: IV.
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Affiliation(s)
- Annie M Q Wang
- Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, ON, Canada
| | - Helene Retrouvey
- Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, ON, Canada
| | - Murray Krahn
- Division of Internal Medicine and Geriatrics, University of Toronto, University Health Network, Toronto, ON, Canada
| | - Steven J McCabe
- Division of Plastic and Reconstructive Surgery, University of Toronto, University Health Network, Toronto, ON, Canada
| | - Heather L Baltzer
- Division of Plastic and Reconstructive Surgery, University of Toronto, University Health Network, Toronto, ON, Canada
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Lu Z, Nazari G, MacDermid JC, Modarresi S, Killip S. Measurement Properties of a 2-Dimensional Movement Analysis System: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2020; 101:1603-1627. [DOI: 10.1016/j.apmr.2020.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 11/29/2022]
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Nazari G, MacDermid JC, Bobos P, Furtado R. Psychometric properties of the Single Assessment Numeric Evaluation (SANE) in patients with shoulder conditions. A systematic review. Physiotherapy 2020; 109:33-42. [PMID: 32858378 DOI: 10.1016/j.physio.2020.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Musculoskeletal injuries (i.e. shoulder pain) is the third most commonly reported symptom. The development of the Single Assessment Numeric Evaluation (SANE) scale has presented clinicians and researchers with a more efficient approach in measuring function. Therefore, it is important to establish the reliability, validity and responsiveness properties of this scale, prior to its application in research and clinic. OBJECTIVES To identify, critically appraise and synthesize the reported psychometric properties of the SANE scale in patients with shoulder related pathologies. DATA SOURCES Medline, Embase, Scopus and CINAHL databases from inception till February 2019 were searched. Two independent reviewers carried out the systematic electronic searches in each database and screened the retrieved studies and assessed their eligibility. STUDY SELECTION OR ELIGIBILITY CRITERIA Randomized/prospective studies, that included patients with shoulder joint related pathologies, that reported on the psychometric properties (reliability, validity, responsiveness) of SANE scale. STUDY APPRAISAL AND SYNTHESIS METHODS The "Quality Appraisal for Clinical Measurement Research Reports Evaluation Form" - a 12-item structured clinical measurement specific appraisal tool was used to assess studies. A qualitative synthesis was performed, and main results summarized based on the shoulder conditions, reported properties and study quality. RESULTS Nine studies were included. The quality ranged from 82% to 95% - very good to excellent quality. SANE scale reliability measures indicated excellent reliability properties. The Intra-class Correlation Coefficient (ICC) was ≥0.80 and Standard Error of Measurement (SEM) ranged from 4.23 to 7.82 points. Validity measures displayed correlations of 0.50-0.88 (moderate to very strong correlations) between the SANE scale and other patient reported outcomes (American Shoulder and Elbow Surgeons, Rowe score, Simple Shoulder Test, Physical Function Computerized Adaptive Test). Four studies assessed SANE scale responsiveness measures. Effect sizes of 1.5 and 0.83; and minimal clinically important differences that ranged from 27.25 to 37.05 (anchor-based approach) and 11.80 to 18.1 (distribution-based approach) were reported. LIMITATIONS Caution must be used when interpreting our ICCs values. CONCLUSION IMPLICATIONS OF KEY FINDINGS Very good to excellent quality evidence indicated that the SANE scale demonstrates evidence of a reliable, valid and responsive tool in patients with shoulder related pathologies. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42018117874.
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Affiliation(s)
- Goris Nazari
- School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada.
| | - Joy C MacDermid
- School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada; Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON, Canada
| | - Pavlos Bobos
- School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, ON, Canada
| | - Rochelle Furtado
- School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, ON, Canada
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Lawson A, Tan AC, Naylor J, Harris IA. Is retrospective assessment of health-related quality of life valid? BMC Musculoskelet Disord 2020; 21:415. [PMID: 32605559 PMCID: PMC7329482 DOI: 10.1186/s12891-020-03434-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 06/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) is a commonly used health outcome. For many acute conditions (e.g. fractures), retrospective measurement of HRQoL is necessary to establish pre-morbid health status. However, the validity of retrospective measurement of HRQoL following an intervening significant health event has not been established. The aim of this study was to test the validity of retrospective measurement (recall) of HRQoL by using a test-retest design to measure reliability and agreement between prospective and retrospective patient-reported HRQoL before and after an intervening health event (elective orthopaedic surgery). METHOD Participants were recruited from the pre-admission clinic of a metropolitan hospital. Participants were assessed for their HRQoL using the EQ-5D-5L at two time-points; prospectively at 2 weeks prior to their date of surgery and then retrospectively (recalling their pre-operative health) following elective hip or knee joint replacement surgery. Prospective measurements were compared with retrospective measurements for the five domain scores (nominal data) using intra-class correlation and for the EQ-Index score and EQ-Visual Analogue Scale (VAS) score (continuous data), using Pearson's correlation. Agreement was tested in continuous variables using Lin's coefficient of concordance (pc) and Bland-Altman plots. RESULTS One hundred seventy-four patients consented to participate. Eighty-eight paired prospective and retrospective scores were collected and there was a median between-test period of 15 days. At a group level, the prospective measurements were similar to the retrospective measurements; the modes and means of the five domain scores were not different and the mean differences (MD) between the scores for EQ-Index (MD = 0.02, on a scale of 0-1) and EQ-VAS (MD = 0.53, on a scale of 1-100) were negligible. However, the correlation of paired scores was varied; the range of domain score correlations was 0.52 to 0.74, the concordance was substantial for the EQ-Index scores (pc = 0.76, 95% CI = 0.66, 0.84) and moderate for the EQ-VAS scores (pc = 0.46, 95% CI = 0.28, 0.61). CONCLUSION Agreement between prospective and retrospective measurements was high at a group level and moderate to substantial at an individual level. Retrospective measurement of HRQoL using the EQ-5D-5L in an orthopaedic clinical context is a valid alternative to using reference data to estimate baseline or pre-morbid health status.
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Affiliation(s)
- Andrew Lawson
- Whitlam Orthopaedic Research Centre, Level 2, Ingham Institute for Applied Medical Research South Western Sydney Clinical School, UNSW Sydney, 1 Campbell St, Liverpool, Sydney, NSW, AUS 2170, Australia.
| | - Aidan C Tan
- Whitlam Orthopaedic Research Centre, Level 2, Ingham Institute for Applied Medical Research South Western Sydney Clinical School, UNSW Sydney, 1 Campbell St, Liverpool, Sydney, NSW, AUS 2170, Australia
| | - Justine Naylor
- Whitlam Orthopaedic Research Centre, Level 2, Ingham Institute for Applied Medical Research South Western Sydney Clinical School, UNSW Sydney, 1 Campbell St, Liverpool, Sydney, NSW, AUS 2170, Australia
| | - Ian A Harris
- Whitlam Orthopaedic Research Centre, Level 2, Ingham Institute for Applied Medical Research South Western Sydney Clinical School, UNSW Sydney, 1 Campbell St, Liverpool, Sydney, NSW, AUS 2170, Australia
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Aghda AK, Asheghan M, Amanollahi A. Comparisons of electrophysiological and clinical findings between young and elderly patients with Carpal Tunnel Syndrome. Rev Neurol (Paris) 2020; 176:387-392. [PMID: 31924311 DOI: 10.1016/j.neurol.2019.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 10/23/2019] [Accepted: 11/07/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Few studies have been published on differences between young and old patients with Carpal Tunnel Syndrome regarding clinical and electrophysiological findings. We compared the findings in participants of two age ranges. METHODS For one year from August 2016, we performed a two-group cross-sectional study in an outpatient clinic of physical medicine and rehabilitation at a University Hospital. Two samples of young and old women with a diagnosis of the syndrome without known risk factors affecting electrophysiological findings were selected. We measured sensory and motor amplitudes and latencies, the conduction velocity of the median nerve, severity, and recurrence of the manifestations, weakness, atrophy, and severity of the syndrome. RESULTS We had two groups of 24 young (<35 years) and 24 old (>65 years) patients with CTS. Severity of symptoms was higher in young participants [Mean (SD) 3.0(0.6) vs. 2.0(0.8), P<0.001]. Muscular weakness was not different [young 2.6(0.88) vs. old 1.9(1.6), P=0.541]. Five young and nine old participants showed thenar wasting (P=0.104). The severity of CTS was similar (P=0.129). For the group young patients, mean sensory amplitude was higher [14.07(10.98) vs. 7.58(5.08), P=0.012], while mean latency was lower [3.86(0.57) vs. 5.15(1.17), P<0.001]. In motor studies, mean latency was more prolonged in the group old patients [3.86(0.57) vs. 5.15(1.17), P<0.001]. CONCLUSION Clinical symptoms are more severe among young people, while the pathophysiological process is more intense in the elderly. Patients should not be clinically judged merely by subjective manifestations. Both diagnostic workup and treatment should be designed holistically with all the evidence taken into consideration.
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Affiliation(s)
- A K Aghda
- Shahid Sadoughi University of Medical Sciences, Yazd, Islamic Republic of Iran.
| | - M Asheghan
- Exercise Physiology Research Center, Baqiyatallah University of Medical Sciences, Mollasadra St, Tehran 1437773787, Islamic Republic of Iran.
| | - A Amanollahi
- Exercise Physiology Research Center, Baqiyatallah University of Medical Sciences, Mollasadra St, Tehran 1437773787, Islamic Republic of Iran.
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Nazari G, Lu S, MacDermid JC. Psychometric Properties of Performance-Based Functional Tests in Patients With Shoulder Pathologies: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2020; 101:1053-1063. [PMID: 31891713 DOI: 10.1016/j.apmr.2019.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 10/19/2019] [Accepted: 11/16/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To identify, critically appraise, and synthesize the reported psychometric properties of shoulder performance-based functional tests in patients with shoulder diseases. DATA SOURCES MEDLINE, Embase, Scopus, and Cumulative Index to Nursing and Allied Health databases from inception until March 2019 were searched. STUDY SELECTION Randomized/prospective studies of patients with shoulder diseases that reported on the psychometric properties (reliability, validity, responsiveness) of performance-based functional tests (Standardized Index of Shoulder Function [FI2S], Functional Impairment Test-Hand and Neck/Shoulder/Arm, Closed Kinetic Chain Upper Extremity Stability Test, Timed Functional Arm and Shoulder Test, Shoulder Function Index [SFInX], and hand to neck, scapula, and opposite scapula). DATA EXTRACTION We used the Consensus-Based Standards for the Selection of Health Measurement Instruments 2018 guideline for systematic reviews. We performed a qualitative synthesis in which the results were summarized based on reported measurement properties and study quality. DATA SYNTHESIS Eight eligible studies were included with 28 measures (16 reliability; 10 validity; 2 responsiveness). Performance-based functional tests reliability (test-retest, intra- and interrater) measures indicated excellent reliability properties. Intraclass correlation coefficient (ICC) was ≥0.83 and standard error of the mean (SEM) ranged from 0.03-13.3 points. Validity (construct/convergent/concurrent) measures displayed correlations of -0.76 to 0.91 between performance-based functional tests and other patient-reported outcomes (Disabilities of the Arm, Shoulder, and Hand, Constant, Shoulder Pain and Disability Index). Two studies assessed the responsiveness measures performance-based functional tests. Effect sizes of 0.44 and 1.50 and minimal clinically important differences of 10.3 using the anchor-based approach were reported. CONCLUSIONS The FI2S and the SFInX are reliable, valid, and responsive in patients with shoulder-related diseases.
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Affiliation(s)
- Goris Nazari
- School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Ontario, Canada.
| | - Steve Lu
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Joy C MacDermid
- School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Ontario, Canada; Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada
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Nazari G, Bobos P, Lu S, MacDermid JC. Psychometric properties of the single assessment numeric evaluation in patients with lower extremity pathologies. A systematic review. Disabil Rehabil 2019; 43:2092-2099. [PMID: 31775536 DOI: 10.1080/09638288.2019.1693641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To identify, critically appraise and synthesize the reported psychometric properties of the Single Assessment Numeric Evaluation in patients with lower extremity pathologies. DATA SOURCES Medline, Embase, Scopus and CINAHL databases from inception till May 2019 were searched. STUDY SELECTION OR ELIGIBILITY CRITERIA Studies that included patients with lower extremity pathologies that reported on the measurement properties of the Single Assessment Numeric Evaluation were included. DATA EXTRACTION Individual studies were appraised by two independent authors to summarize the quality of available evidence, using the COSMIN 2018 guidelines for systematic reviews of patient reported outcome measures. The results were descriptively summarized and reported. DATA SYNTHESIS Nine eligible studies were included. The Single Assessment Numeric Evaluation reliability measures indicated coefficients of variation <1% (doubtful quality; indeterminate properties). Validity measures displayed correlations of 0.51-0.88 between the Single Assessment Numeric Evaluation and International Knee Documentation Committee, Western Ontario/McMaster Universities Osteoarthritis Index, Knee Outcome Survey, and Revised Foot Function Index. Two measurement studies assessed the Single Assessment Numeric Evaluation responsiveness measures. Effect sizes of ≥1.75; and minimal clinically important differences of 7.0 (6 months) and 19.0 (12 months) follow ups were reported. CONCLUSION Adequate quality evidence with sufficient measurement properties demonstrated that the Single Assessment Numeric Evaluation is a valid tool in assessing perception of condition in female participants with knee injuries and in military population patients with ankle sprains.Implications for rehabilitationSingle Assessment Numeric Evaluation is a valid and responsive tool in assessing perception of condition in female participants with knee injuries.Single Assessment Numeric Evaluation is a valid tool in assessing perception of condition in military population patients with ankle sprains.
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Affiliation(s)
- Goris Nazari
- Faculty of Health Science, School of Physical Therapy, Western University, London, Canada.,Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Canada
| | - Pavlos Bobos
- Faculty of Health Science, School of Physical Therapy, Western University, London, Canada.,Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Canada
| | - Steve Lu
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Joy C MacDermid
- Faculty of Health Science, School of Physical Therapy, Western University, London, Canada.,Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Canada.,Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Canada
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Tezel N, Umay E, Yılmaz V, Cakci A. Acupuncture plus night splint for quality of life and disability in patients with carpal tunnel syndrome: a randomized controlled trial. Integr Med Res 2019; 8:284-288. [PMID: 31828011 PMCID: PMC6889040 DOI: 10.1016/j.imr.2019.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 11/17/2022] Open
Abstract
Background Carpal tunnel syndrome (CTS) is a common condition caused by pressure on a nerve in the wrist. This study aimed to evaluate the effects of acupuncture plus night splinting on quality of life, function and pain in patients with CTS. Methods This research is a prospective randomized, single-center trial. Acupuncture and night splinting was applied two times a week for five weeks, while the control group received night splinting only. Outcomes measured were Quality of life (Nottingham Health Profile, NHP), function (Boston Carpal Tunnel Questionnaire) and pain (visual analogue scale, VAS). Results At the end of the treatment, the acupuncture plus splinting group showed more reduction in the pain level than the splinting group (p = 0.007). The change in the pain subscale of the NHP was significantly reduced in the acupuncture plus night splinting group than the night splinting group (p = 0.001). The change in sleep and physical activity subscale of the NHP score failed to show significant differences between the two groups. The functional scores also failed to show the signficant differences between the two groups. Conclusion The effect of acupuncture plus night splinting may show significant reduction on pain but failed to show significant differences on the other outcomes compared to the night splinting group. Further studies with larger sample size may confirm the findings.
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Affiliation(s)
- Nihal Tezel
- Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Department of Physical Medicine And Rehabilitation, Ankara, Turkey
| | - Ebru Umay
- Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Department of Physical Medicine And Rehabilitation, Ankara, Turkey
| | - Volkan Yılmaz
- Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Department of Physical Medicine And Rehabilitation, Ankara, Turkey
| | - Aytul Cakci
- Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Department of Physical Medicine And Rehabilitation, Ankara, Turkey
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Furtado R, Nazari G, MacDermid JC. A systematic review of the cross-cultural adaptations and measurement properties of the Shoulder Pain and Disability Index. HAND THERAPY 2019. [DOI: 10.1177/1758998319876953] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Rochelle Furtado
- Physiotherapy, Health and Rehabilitation Science, Western University, London, Canada
- Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Canada
| | - Goris Nazari
- Physiotherapy, Health and Rehabilitation Science, Western University, London, Canada
- Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Canada
| | - Joy C MacDermid
- Physiotherapy, Health and Rehabilitation Science, Western University, London, Canada
- Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, Canada
- Roth McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, Canada
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Grobet C, Marks M, Tecklenburg L, Audigé L. Application and measurement properties of EQ-5D to measure quality of life in patients with upper extremity orthopaedic disorders: a systematic literature review. Arch Orthop Trauma Surg 2018; 138:953-961. [PMID: 29654354 DOI: 10.1007/s00402-018-2933-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Indexed: 01/05/2023]
Abstract
INTRODUCTION The EuroQol-5 Dimension (EQ-5D) is the most widely used generic instrument to measure quality of life (QoL), yet its application in upper extremity orthopaedics as well as its measurement properties remain largely undefined. We implemented a systematic literature review to provide an overview of the application of EQ-5D in patients with upper extremity disorders and analyse its measurement properties. MATERIALS AND METHODS We searched Medline, EMBASE, Cochrane and Scopus databases for clinical studies including orthopaedic patients with surgical interventions of the upper extremity who completed the EQ-5D. For all included studies, the use of EQ-5D and quantitative QoL data were described. Validation studies of EQ-5D were assessed according to COSMIN guidelines and standard measurement properties were examined. RESULTS Twenty-three studies were included in the review, 19 of which investigated patients with an intervention carried out at the shoulder region. In 15 studies, EQ-5D assessed QoL as the primary outcome. Utility index scores in non-trauma patients generally improved postoperatively, whereas trauma patients did not regain their recalled pre-injury QoL levels. EQ-5D measurement properties were reported in three articles on proximal humerus fractures and carpal tunnel syndrome. Positive ratings were seen for construct validity (Spearman correlation coefficient ≥ 0.70 with the Short Form (SF)-12 or SF-6D health surveys) and reliability (intraclass correlation coefficient ≥ 0.77) with intermediate responsiveness (standardised response means: 0.5-0.9). However, ceiling effects were identified with 16-48% of the patients scoring the maximum QoL. The methodological quality of the three articles varied from fair to good. CONCLUSIONS For surgical interventions of the upper extremity, EQ-5D was mostly applied to assess QoL as a primary outcome in patients with shoulder disorders. Investigations of the measurement properties were rare, but indicate good reliability and validity as well as moderate responsiveness in patients with upper extremity conditions.
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Affiliation(s)
- Cécile Grobet
- Department of Teaching, Research and Development, Schulthess Klinik, Lengghalde 2, 8008, Zurich, Switzerland.
| | - Miriam Marks
- Department of Teaching, Research and Development, Schulthess Klinik, Lengghalde 2, 8008, Zurich, Switzerland
| | - Linda Tecklenburg
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Gertrudstrasse 15, 8401, Winterthur, Switzerland
| | - Laurent Audigé
- Department of Teaching, Research and Development, Schulthess Klinik, Lengghalde 2, 8008, Zurich, Switzerland
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Jerosch-Herold C, Houghton J, Blake J, Shaikh A, Wilson ECF, Shepstone L. Association of psychological distress, quality of life and costs with carpal tunnel syndrome severity: a cross-sectional analysis of the PALMS cohort. BMJ Open 2017; 7:e017732. [PMID: 29102992 PMCID: PMC5722090 DOI: 10.1136/bmjopen-2017-017732] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The Prediciting factors for response to treatment in carpal tunnel syndrome (PALMS) study is designed to identify prognostic factors for outcome from corticosteroid injection and surgical decompression for carpal tunnel syndrome (CTS) and predictors of cost over 2 years. The aim of this paper is to explore the cross-sectional association of baseline patient-reported and clinical severity with anxiety, depression, health-related quality of life and costs of CTS in patients referred to secondary care. METHODS Prospective, multicentre cohort study initiated in 2013. We collected baseline data on patient-reported symptom severity (CTS-6), psychological status (Hospital Anxiety and Depression Scale), hand function (Michigan Hand Questionnaire) comorbidities, EQ-5D-3L (3-level version of EuroQol-5 dimension) and sociodemographic variables. Nerve conduction tests classified patients into five severity grades (mild to very severe). Data were analysed using a general linear model. RESULTS 753 patients with CTS provided complete baseline data. Multivariable linear regression adjusting for age, sex, ethnicity, duration of CTS, smoking status, alcohol consumption, employment status, body mass index and comorbidities showed a highly statistically significant relationship between CTS-6 and anxiety, depression and the EQ-5D (p<0.0001 in each case). Likewise, a significant relationship was observed between electrodiagnostic severity and anxiety (p=0.027) but not with depression (p=0.986) or the EQ-5D (p=0.257). National Health Service (NHS) and societal costs in the 3 months prior to enrolment were significantly associated with self-reported severity (p<0.0001) but not with electrodiagnostic severity. CONCLUSIONS Patient-reported symptom severity in CTS is significantly and positively associated with anxiety, depression, health-related quality of life, and NHS and societal costs even when adjusting for age, gender, body mass index, comorbidities, smoking, drinking and occupational status. In contrast, there is little or no evidence of any relationship with objectively derived CTS severity. Future research is needed to understand the impact of approaches and treatments that address psychosocial stressors as well as biomedical factors on relief of symptoms from carpal tunnel syndrome.
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Affiliation(s)
- Christina Jerosch-Herold
- Faculty of Medicine and Health Sciences, School of Health, Sciences, University of East Anglia, Norwich, UK
| | - Julie Houghton
- Faculty of Medicine and Health Sciences, School of Health, Sciences, University of East Anglia, Norwich, UK
| | - Julian Blake
- Department of Clinical Neurophysiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
- Department of Clinical Neurophysiology, MRC Centre for Neuromuscular Diseases, London, UK
| | - Anum Shaikh
- Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Edward CF Wilson
- Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Lee Shepstone
- Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich, UK
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