Purpose
Arm-, region-, tissue-, and condition-specific patient-reported outcome measures (PROMs)
are available to address idiopathic mononeuropathy. This study compared PROMs with
varying specificities in patients with idiopathic neuropathy of the upper extremity
with respect to correlations with each another, sources of variation in scores, and
floor and ceiling effects.
Methods
One hundred fifty patients (130 with carpal tunnel syndrome, 30 with cubital tunnel
syndrome, and 10 with both conditions) completed a nerve-specific PROM (Impact of
Hand Nerve Disorders), a condition-specific PROM (Boston Carpal Tunnel Syndrome Questionnaire
and/or Patient-Rated Ulnar Nerve Evaluation), and an upper extremity–specific PROM
(Patient-Reported Outcomes Measurement Information System Physical Function Upper
Extremity 7). We also gathered demographic and condition-related data (side, electrodiagnostic
studies present, muscle atrophy, static loss of sensibility), and patients completed
questionnaires measuring self-efficacy, kinesiophobia, and symptoms of depression.
Correlation of the PROMs with each another and factors accounting for their variation
were assessed, as well as the number of items to complete, time to complete, and floor
and ceiling effects.
Results
Pearson correlations between PROMs were moderate to strong (0.56–0.90). Self-reported
symptoms of depression were best able to account for the variations in symptom intensity
and activity intolerance on all PROMs (adjusted R2 between 0.09 and 0.31). The Impact of Hand Nerve Disorders is a long questionnaire
and took the most time to complete. All instruments had comparable floor effects;
Patient-Reported Outcomes Measurement Information System Physical Function Upper Extremity
had a ceiling of effect of 16%.
Conclusions
This study adds to the evidence that specific and general PROMs correlate with each
another, perhaps in part through their correlation with mental health. Based on this
line of evidence and pending testing of potentially greater responsiveness in specific
settings, we prefer to use a single simple, brief, and general PROM to quantify symptom
intensity and activity intolerance for both routine patient care and research.
Type of study/level of evidence
Prognostic II.
Key words
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Article info
Publication history
Published online: August 24, 2021
Accepted:
July 9,
2021
Received:
September 28,
2020
Footnotes
Dr Ring has received or may receive payment or benefits from Skeletal Dynamics, universities, hospitals, and lawyers outside the submitted work; has received or may receive payment or benefits from Wright Medical for elbow implants; and is the Deputy Editor for Clinical Orthopaedics and Related Research. No benefits in any form have been received or will be received by the other author(s) related directly or indirectly to the subject of this article.
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