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

Abstract

BackgroundThe 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).MethodsA 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.ResultsCronbach’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.ConclusionsThe CTSI-JSSH has sufficient reliability, validity, and responsiveness to assess the health status in carpal tunnel syndrome.

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

“…In a study of the Portuguese version, factor analysis of both scales combined showed that items 7 and 11 associated mainly with the functional status scale items [10]. In a factor analysis of the Japanese version of the symptom severity scale, item 7 had low loadings in a 2-factor model and item 11 had the lowest loading in a 1-factor model [11]. The factor analysis of the 11-item symptom severity scale showed that items 7 and 11 were more associated with functional status items, which questions the inclusion of these two items in a symptoms scale.…”

“…However, these scales were developed without examining their latent structure using, for example, factor analysis. To our knowledge, the latent structure of the symptom severity and functional status scales has subsequently been examined in only two translated versions of the scales [10,11]. Moreover, all previous studies that assessed the CTS scales used classical test methodology and involved relatively small populations.…”

The Relationship Between Neuropathic Pain, and the Function of the Upper Limbs Based on Clinical Severity According to Electrophysiological Studies in Patients with Carpal Tunnel Syndrome

“…Some of them are disease-specific measures such as the Brigham and Women’s Carpal Tunnel Questionnaire [13] or the Carpal Tunnel Syndrome Instrument [17, 18]. …”

Electrophysiological Assessment for Splinting in the Treatment of Carpal Tunnel Syndrome

“…Additionally, for the clinical evaluation before and after wrist splinting, we used two patient-oriented questionnaires which have been recognized as important tools and which have been widely used for CTS; the Japanese Society for Surgery of the Hand version-Quick Disability of Arm, Shoulder, and Hand questionnaire (QuickDASH-JSSH) 10,11) and the Japanese Society for Surgery of the Hand version of the Carpal Tunnel Syndrome Instrument (CTSI-JSSH), 11,12) which consisted of a Symptom Severity Scale (CTSI-JSSH-SS) and Functional Status Scale (CTSI-JSSH-FS). The QuickDASH was developed as a shortened version of the Disability of Arm, Shoulder, and Hand questionnaire (DASH) outcome measurement.…”

“…10,11) The CTSI-JSSH is a Japanese version of the self-administered disease-specific questionnaire for the assessment of the symptom severity and functional score consisting of two scales. 11,12) The CTSI-JSSH-SS and the CTSI-JSSH-FS have 11 and 8 questions, respectively. The assessment of each question was on a score of 1 point to 5 points, in which 1 indicates no symptom and 5 indicates severe symptoms.…”