Hospital of the University of Pennsylvania, Philadelphia, USA.
Hospital for Special Surgery, New York, NY, USA.
Hand (N Y). 2023 Jan;18(1_suppl):71S-76S. doi: 10.1177/15589447211072226. Epub 2022 Feb 21.
With the expanded indications for telemedicine, there is increased utility for screening methods to determine which patients are likely to progress to surgical intervention, requiring in-person visits. Patient-rated tools such as the Boston Carpal Tunnel Questionnaire (BCTQ) may be one such tool for screening patients with carpal tunnel syndrome (CTS). The aim of the study was to evaluate whether BCTQ scores were predictive of offering conservative treatment or surgical intervention for CTS.
Patients diagnosed with CTS from January 2017 to February 2020 completed BCTQ questionnaires prior to in-person office visits. Demographics, comorbidities, and highest level of intervention recommended were recorded for each patient as conservative, injection, or surgery. Pearson χ and independent-samples tests were conducted to determine whether BCTQ symptom severity and functional scores were associated with intervention type.
A total of 200 patients with CTS were included. Of these, 103 were recommended conservative or injection treatment and 97 were recommended surgery. There were no differences in comorbidities between groups, including other upper extremity pathology ( = .57), previous upper extremity surgery ( = .32), hypertension ( = .17), hypothyroidism ( = .15), rheumatoid arthritis ( = .34), and diabetes ( = .30). Between these groups, there were no differences in BCTQ symptom severity score (symptom severity scale [SSS]; = .16) or BCTQ functional severity score (functional severity scale [FSS]; = .96).
There is no correlation between comorbidities and BCTQ SSS or FSS score, and offering surgery for CTS. In an era of minimizing non-essential health care visits, the BCTQ is insufficient in screening patients as potential surgical candidates.
随着远程医疗适应症的扩大，需要使用筛选方法来确定哪些患者可能需要进行手术干预，需要进行面对面的就诊，因此患者自评工具（如波士顿腕管综合征问卷（BCTQ））的使用越来越多。该研究旨在评估 BCTQ 评分是否可用于预测腕管综合征（CTS）患者接受保守治疗或手术干预。
2017 年 1 月至 2020 年 2 月期间，在门诊就诊前，被诊断为 CTS 的患者完成 BCTQ 问卷。记录每位患者的人口统计学、合并症和建议的最高干预措施，包括保守、注射或手术。采用 Pearson χ 和独立样本 t 检验来确定 BCTQ 症状严重程度和功能评分与干预类型是否相关。
共纳入 200 例 CTS 患者。其中，103 例建议保守或注射治疗，97 例建议手术治疗。两组之间的合并症无差异，包括其他上肢病理学（ =.57）、上肢手术史（ =.32）、高血压（ =.17）、甲状腺功能减退症（ =.15）、类风湿关节炎（ =.34）和糖尿病（ =.30）。在这两组之间，BCTQ 症状严重程度评分（症状严重程度量表[SSS]； =.16）或 BCTQ 功能严重程度评分（功能严重程度量表[FSS]； =.96）无差异。
在 CTS 患者中，手术的建议与合并症和 BCTQ SSS 或 FSS 评分之间没有相关性。在尽量减少非必要医疗保健就诊的时代，BCTQ 在筛选潜在手术候选者方面不足。
