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Is it time to revisit the Boston Carpal Tunnel Questionnaire? New insights from a Rasch model analysis
Christina Jerosch-Herold1, Jeremy D P Bland2, Mike Horton3
1Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
Muscle & Nerve
|January 17, 2021
Summary
The Boston Carpal Tunnel Questionnaire (BCTQ) is not a valid single measure for carpal tunnel syndrome (CTS). Separate analysis of Symptom Severity Subscale (SSS) and Functional Status Subscale (FSS) is recommended, with a proposed scoring adjustment for the SSS.
Area of Science:
- Orthopedics
- Rheumatology
- Psychometrics
Background:
- The Boston Carpal Tunnel Questionnaire (BCTQ) is a widely used patient-reported outcome measure (PROM) for carpal tunnel syndrome (CTS).
- Limited research has investigated the BCTQ's measurement properties using modern psychometric methodologies.
Purpose of the Study:
- To evaluate the structural validity and measurement properties of the BCTQ.
- To apply Rasch model analysis to BCTQ data.
Main Methods:
- Rasch model analysis was applied to BCTQ data from 600 patients with confirmed CTS.
- Items were analyzed for reliability, fit, targeting, differential item functioning, and dimensionality.
Main Results:
- A single total score for the BCTQ was found to be psychometrically invalid.
- The Symptom Severity Subscale (SSS) required testlet creation for linear transformation.
- The Functional Status Subscale (FSS) exhibited significant psychometric integrity issues.
Conclusions:
- The BCTQ Symptom Severity Subscale (SSS) and Functional Status Subscale (FSS) should be analyzed separately.
- A modified scoring system for the SSS is proposed to enable linear measure transformation.
- Findings highlight the need for careful interpretation of BCTQ total scores.
