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The 6-item CTS symptoms scale: a brief outcomes measure for carpal tunnel syndrome

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Abstract

Objective

To develop a psychometrically appropriate brief symptoms measure of carpal tunnel syndrome (CTS).

Methods

Preoperative CTS 11-item symptom severity and 8-item functional status scales from 693 patients (71% women) with CTS were subjected to exploratory factor analysis and item response theory (IRT) analysis yielding a revised CTS symptoms scale. A validation sample of 213 patients (68% women) with CTS completed the 11-item disabilities of the arm, shoulder and hand (QuickDASH), and the revised symptoms scale and 116 patients also completed the original CTS symptom severity scale (median interval 11 days).

Results

Of the 11 CTS symptom severity scale items, 2 items that on factor analysis associated with the functional status items were removed. After IRT recalibrations of the remaining symptom severity scale items, 2 non-fitting items were removed and 2 items were merged creating the 6-item CTS symptoms scale. Factor analysis showed one dominant factor explaining 58% of the variance. Reliability was high (Cronbach alpha = 0.86; IRT person separation reliability = 0.88). No item displayed significant differential item functioning. The 6-item CTS symptoms scale showed strong correlation with the QuickDASH (r = 0.70) and agreement with the original symptom severity scale (ICC = 0.80).

Conclusion

The 6-item CTS symptoms scale has good reliability and validity and can be used to measure symptom severity and treatment outcome in CTS.

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Abbreviations

CTS:

Carpal tunnel syndrome

DASH:

Disabilities of the arm, shoulder and hand

EFA:

Exploratory factor analysis

IRT:

Item response theory

PCM:

Partial credit model

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Acknowledgment

Funding

This research was supported by Skane county council’s research and development foundation, Hässleholm Hospital, and Umeå University, Sweden.

Author information

Authors and Affiliations

  1. Department of Clinical Sciences, Lund University, Lund, Sweden

    Isam Atroshi

  2. Department of Orthopedics, Hässleholm and Kristianstad Hospitals, 28125, Hässleholm, Sweden

    Isam Atroshi

  3. Department of Educational Measurement, Umeå University, 90187, Umea, Sweden

    Per-Erik Lyrén

  4. Department of Health Sciences, Division of Physiotherapy, Lund University, 22100, Lund, Sweden

    Christina Gummesson

Authors
  1. Isam Atroshi
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  2. Per-Erik Lyrén
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  3. Christina Gummesson
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Corresponding author

Correspondence to Isam Atroshi.

Appendix

Appendix

The 6-item CTS symptoms scale

Table 6 The following questions refer to your symptoms for a typical 24-h period during the past 2 weeks. Mark one answer to each symptom
Full size table

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Atroshi, I., Lyrén, PE. & Gummesson, C. The 6-item CTS symptoms scale: a brief outcomes measure for carpal tunnel syndrome. Qual Life Res 18, 347–358 (2009). https://doi.org/10.1007/s11136-009-9449-3

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