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Validation of a Quick Carpal Tunnel Syndrome-6 Questionnaire as a Diagnostic Tool for Carpal Tunnel Syndrome
Joydeep Baidya1, Evan Johnson1, Joshua Pang1
1Rothman Orthopaedic Institute, Philadelphia, PA, USA.
Background:
Carpal tunnel syndrome is common, and carpal tunnel syndrome-6 (CTS-6) is a validated diagnostic tool; however, its weighted scoring limits rapid use. We evaluated a simplified quick carpal tunnel syndrome-6 (QCTS-6) for diagnostic accuracy.
Methods:
Carpal tunnel releases performed at a tertiary care center (January 2017-August 2024) were retrospectively identified. Preoperative presence or absence of the components of the CTS-6 were reviewed and assigned the corresponding number of points. For the QCTS-6 scoring system, 0 or 1 point was assigned for a total score out of 6. Preoperative electromyography (EMG)/nerve conduction study (NCS) results were collected when available. Descriptive statistics, Spearman's Rho correlations, and diagnostic ratio tests were performed.
Results:
A total of 1143 patients met the inclusion criteria. There was a strong positive relationship between the CTS-6 and QCTS-6 scores for the overall cohort (r = 0.976). Patients with QCTS-6 score of 3 or more exhibited the presence of all questionnaire components and severe EMG/NCS findings at higher rates, with 98.2% of them having CTS-6 scores greater than 12. Diagnostic ratio testing identified numbness in the median nerve territory, nocturnal numbness, and loss of 2-point discrimination as the most balanced predictive factors.
Conclusions:
The QCTS-6 scoring system can be a valid alternative to the traditional CTS-6. Owing to its uniform scoring, it can allow for efficient workup without necessitating EMG/NCS. A score of 3 or more may serve as a sensitive cutoff for carpal tunnel syndrome.
