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Generic health instruments do not comprehensively capture patient perceived improvement in patients with carpal
J H Vaile1, D M Mathers, C Ramos-Remus
1Department of Medicine, University of Alberta, Edmonton, Canada.
Objective:
To assess the sensitivity to change of general quality of life indices in patients with rheumatic diseases, we assessed the performance of 4 instruments in patients with carpal tunnel syndrome (CTS) treated with local injection of corticosteroid.
Methods:
We administered visual analog scales (VAS) incorporating measures of overall well being, discomfort, frequency of symptoms, and physical activity; 2 generic instruments [the Nottingham Health Profile (NHP), the Medical Outcomes Study 36 Item Short Form (SF-36)]; and a rheumatoid arthritis-specific instrument, the modified Health Assessment Questionnaire, at baseline and one month after injection. We assessed 30 patients.
Results:
VAS were significantly better at determining improvement than the generic instruments or the arthritis specific instrument. For the generic scales, only the pain scales of NHP and SF-36 showed moderate or greater change using standardized response means.
Conclusion:
These results suggest that standard tools may not be sufficiently sensitive to show clinically significant change in this common rheumatological problem.