Reliability and construct validity of the Spanish version of the 6-item CTS symptoms scale for outcomes assessment in ca
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RESEARCH ARTICLE
Open Access
Reliability and construct validity of the Spanish version of the 6-item CTS symptoms scale for outcomes assessment in carpal tunnel syndrome Roberto S. Rosales1*, Yolanda Martin-Hidalgo2, Luis Reboso-Morales2 and Isam Atroshi3,4
Abstract Background: The purpose of this study was to assess the reliability and construct validity of the Spanish version of the 6-item carpal tunnel syndrome (CTS) symptoms scale (CTS-6). Methods: In this cross-sectional study 40 patients diagnosed with CTS based on clinical and neurophysiologic criteria, completed the standard Spanish versions of the CTS-6 and the disabilities of the arm, shoulder and hand (QuickDASH) scales on two occasions with a 1-week interval. Internal-consistency reliability was assessed with the Cronbach alpha coefficient and test-retest reliability with the intraclass correlation coefficient, two way random effect model and absolute agreement definition (ICC2,1). Cross-sectional precision was analyzed with the Standard Error of the Measurement (SEM). Longitudinal precision for test-retest reliability coefficient was assessed with the Standard Error of the Measurement difference (SEMdiff) and the Minimal Detectable Change at 95 % confidence level (MDC95). For assessing construct validity it was hypothesized that the CTS-6 would have a strong positive correlation with the QuickDASH, analyzed with the Pearson correlation coefficient (r). Results: The standard Spanish version of the CTS-6 presented a Cronbach alpha of 0.81 with a SEM of 0.3. Test-retest reliability showed an ICC of 0.85 with a SRMdiff of 0.36 and a MDC95 of 0.7. The correlation between CTS-6 and the QuickDASH was concordant with the a priori formulated construct hypothesis (r 0.69) Conclusions: The standard Spanish version of the 6-item CTS symptoms scale showed good internal consistency, test-retest reliability and construct validity for outcomes assessment in CTS. The CTS-6 will be useful to clinicians and researchers in Spanish speaking parts of the world. The use of standardized outcome measures across countries also will facilitate comparison of research results in carpal tunnel syndrome. Keywords: Carpal tunnel syndrome, CTS-6 symptoms scale, Patient-reported outcomes, Carpal tunnel release, QuickDASH
Background The use of disease-specific measures of patient-reported outcomes (PRO) has grown in clinical research. Carpal tunnel syndrome (CTS) is one of the most frequent conditions managed at hand surgery services. The CTS questionnaire developed by Levine et al. [1] has been among the most widely used PRO measures during the last two decades. The CTS questionnaire consists of two * Correspondence: [email protected] 1 Unit for Hand & Microsurgery, GECOT, La Laguna, Tenerife, Spain Full list of author information is available at the end of the article
scales: symptoms severity (SS) (11 items) and functional status (FS). Atroshi et al. [2], using factor analysis and Items Response Theory methodology, developed a short version of the CTS SS-scale consistin
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