title: Generic health instruments do not comprehensively capture patient perceived improvement in patients with carpal tunnel syndrome.
abstract: 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.
  
  
  CONCLUSIONS
  These results suggest that standard tools may not be sufficiently sensitive to show clinically significant change in this common rheumatological problem.
authors.affiliation: Department of Medicine, University of Alberta, Edmonton, Canada.
authors.forename: J H
authors.initials: JH
authors.lastname: Vaile
authors.forename: D M
authors.initials: DM
authors.lastname: Mathers
authors.forename: C
authors.initials: C
authors.lastname: Ramos-Remus
authors.forename: A S
authors.initials: AS
authors.lastname: Russell
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010147:Pain Measurement; D011788:Quality of Life; D012680:Sensitivity and Specificity
chemical_list: D000305:Adrenal Cortex Hormones