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- Title
Measuring symptoms severity in carpal tunnel syndrome: score agreement and responsiveness of the Atroshi-Lyrén 6-item symptoms scale and the Boston symptom severity scale.
- Authors
Möllestam, Kamelia; Rosales, Roberto S.; Lyrén, Per-Erik; Atroshi, Isam
- Abstract
<bold>Purpose: </bold>To assess score agreement between the Atroshi-Lyrén 6-item symptoms scale and the Boston 11-item symptom severity scale and compare their responsiveness in patients with carpal tunnel syndrome before and after carpal tunnel release surgery.<bold>Methods: </bold>This prospective cohort study included 3 cohorts that completed the A-L and Boston scales (conventional score 1-5) on the same occasion: a preoperative and short-term postoperative cohort (212 patients), a mid-term postoperative cohort (101 patients), and a long-term postoperative cohort (124 patients). Agreement was assessed with Lin's concordance correlation coefficient and Passing-Bablok regression analysis. Analyses using item response theory were conducted on responses from the preoperative/short-term postoperative cohort including testing of item infit/outfit. Reliability was assessed with Cronbach alpha. Overall and sex-specific effect sizes were calculated using Cohen's d.<bold>Results: </bold>Lin's CCCs were high (0.81-0.91). Passing-Bablok analysis showed constant and proportional differences in all cohorts except preoperative to short-term postoperative change. Both scales showed high reliability (alpha, 0.88-0.93). The IRT-based analyses showed infit/outfit values within the desired range. With IRT-based scoring, the A-L scale had significantly higher responsiveness than the Boston scale, overall (d, 2.02 vs 1.59), in women (d, 2.22 vs 1.77) and in men (d, 1.74 vs 1.36).<bold>Conclusion: </bold>The Atroshi-Lyrén 6-item symptoms scale and the Boston 11-item symptom severity scale show good agreement but are not equivalent in measuring CTS-related symptoms severity. When using IRT-based scoring, the Atroshi-Lyrén scale demonstrated significantly higher responsiveness.
- Subjects
QUALITY of life; MENTAL health; CARPAL tunnel syndrome; RESEARCH evaluation; PREOPERATIVE period; SEVERITY of illness index; POSTOPERATIVE pain; LONGITUDINAL method; SYMPTOMS
- Publication
Quality of Life Research, 2022, Vol 31, Issue 5, p1553
- ISSN
0962-9343
- Publication type
journal article
- DOI
10.1007/s11136-021-03039-1