A Comparison of DASH, PEM and Levine questionnaires in outcome measurement of carpal tunnel release.

The objective of this study was to compare the 3 commonly used questionnaires DASH, PEM and Levine to assess which is the best as an outcome measure after carpal tunnel release. 50 patients (43 women and 7 men) with an average age of 56 years underwent minimally invasive carpal tunnel release. Patients were examined before the operation, and at 1 and 6 months after, according to the same protocol. They completed the DASH, PEM and Levine questionnaires and undertook total grip, key-pinch strengths, and sensation by filament tests. The results showed higher responsiveness to change in the Levine and the PEM, compared to the DASH at the 1- and 6-month-assessments. The Levine showed the highest validity as it correlated strongly with all functional measures, although all 3 questionnaires, including Levine, showed a discordance with total grip and key-pinch strength at the 1-month assessment. The instruments were characterized by various (excellent and poor) concurrent validity in the assumed periods of observation and all 3 showed high internal consistency.