De Kleermaeker Floriaan G C M, Boogaarts Hieronymus D, Meulstee Jan, Verhagen Wim I M
1 Department of Neurology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
2 Department of Neurosurgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
J Hand Surg Eur Vol. 2019 Mar;44(3):283-289. doi: 10.1177/1753193418812616. Epub 2018 Nov 21.
No consensus exists about the minimal clinically important difference for the Boston Carpal Tunnel Questionnaire, which hampers its clinical application. This study assessed the minimal clinically important difference of this questionnaire. The Boston Carpal Tunnel Questionnaire was completed by 180 patients, with clinically defined carpal tunnel syndrome, preoperatively and at about 8 months follow-up after carpal tunnel release, together with a six-point scale for perceived improvement. Receiver operator characteristics curves showed that relative changes in Symptom Severity Scale and Functional Status Scale scores correspond better to a clinically relevant improvement than absolute changes. The minimal clinically important difference should be individually calculated from baseline Symptom Severity Scale and Functional Status Scale scores, as patients experiencing more symptoms require more improvement to notice a clinically important difference. By taking this into account, the Boston Carpal Tunnel Questionnaire is more meaningful as an outcome measure in research and clinical practice.
对于波士顿腕管综合征问卷的最小临床重要差异尚无共识，这妨碍了其临床应用。本研究评估了该问卷的最小临床重要差异。180例临床诊断为腕管综合征的患者在术前及腕管松解术后约8个月随访时完成了波士顿腕管综合征问卷，并采用六点量表评估感觉改善情况。受试者工作特征曲线显示，症状严重程度量表和功能状态量表得分的相对变化比绝对变化更能反映临床相关的改善情况。最小临床重要差异应根据症状严重程度量表和功能状态量表的基线得分单独计算，因为症状较多的患者需要更大程度的改善才能察觉到临床重要差异。考虑到这一点，波士顿腕管综合征问卷作为研究和临床实践中的一项结局指标更有意义。
