Structural validity of the Boston Carpal Tunnel Questionnaire and its short version, the 6-Item CTS symptoms scale: a Rasch analysis one year after surgery

Background The Boston Carpal Tunnel Questionnaire (BCTQ) and its shorter version, the Six-Item Carpal Tunnel Symptoms Scale (CTS-6), are widely used for assessing function and/or symptoms in patients with carpal tunnel syndrome. This study examined the structural validity of the BCTQ and CTS-6 among...

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Published in:BMC musculoskeletal disorders Vol. 21; no. 1; pp. 609 - 14
Main Authors: Multanen, Juhani, Ylinen, Jari, Karjalainen, Teemu, Ikonen, Joona, Häkkinen, Arja, Repo, Jussi P.
Format: Journal Article
Language:English
Published: London BioMed Central 12.09.2020
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Adult
Age
Analysis
Boston Carpal Tunnel Questionnaire
Carpal Tunnel Release
Carpal tunnel syndrome
Carpal Tunnel Syndrome - diagnosis
Carpal Tunnel Syndrome - surgery
Cross-Sectional Studies
Epidemiology
Humans
Internal Medicine
Medical research
Medicine
Medicine & Public Health
Musculoskeletal diseases
Orthopedics
Orthopedics and biomechanics
Pain
Patients
Principal components analysis
Psychometrics
Quantitative psychology
Questionnaires
Rasch analysis
Rasch model
Rehabilitation
Research Article
Rheumatology
Sex differences
Six-Item Carpal Tunnel Symptoms Scale
Sports Medicine
Surgery
Surveys
Surveys and Questionnaires
Validation studies
Validity
Wrist
Finland
Rasch analysis
Six-Item Carpal Tunnel Symptoms Scale
Psychometrics
Carpal Tunnel Release
Boston Carpal Tunnel Questionnaire
ISSN:1471-2474, 1471-2474
Online Access:Get full text
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Summary:Background The Boston Carpal Tunnel Questionnaire (BCTQ) and its shorter version, the Six-Item Carpal Tunnel Symptoms Scale (CTS-6), are widely used for assessing function and/or symptoms in patients with carpal tunnel syndrome. This study examined the structural validity of the BCTQ and CTS-6 among patients who had undergone surgery for treatment of carpal tunnel syndrome. Methods The data for this cross-sectional analysis were obtained from 217 adult patients who had undergone carpal tunnel release surgery 1 year earlier. All patients completed the CTS-6, Symptom Severity Scale (SSS) and Functional Status Scale (FSS) of the BCTQ at 12 months after surgery. The Rasch Measurement Theory (RMT) was applied to investigate the unidimensionality, residual correlation, differential item functioning, scale coverage/targeting, and person separation of the CTS-6, SSS and FSS of the BCTQ. Results The FSS showed unidimensionality and good scale and item fit. All items showed ordered response category thresholds. Eight of the FSS items displayed differential item functioning favoring age or gender. The multidimensional structure of the CTS-6 was absorbed by creating a testlet for frequency of symptoms or testlets for pain and numbness. The testlets supported unidimensionality in the BCTQ SSS. One item in the CTS-6 and two items in the BCTQ SSS showed differential item functioning favoring age or gender. Four items in the BCTQ SSS and two items in the CTS-6 exhibited disordered response category thresholds. Merging of the relevant response categories led to ordered response category thresholds. The person separation indices were 0.73, 0.86 and 0.77 for the CTS-6, BCTQ SSS and FSS, respectively. Conclusions Based on the RMT analysis, the CTS-6 has superior psychometric properties compared to the BCTQ SSS in surgically treated patients. The CTS-6 might be more accurate when separated into item sets measuring pain or numbness. The FSS of the BCTQ has acceptable construct validity, although gender differences at some ages were observed in responses.
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ISSN:1471-2474
1471-2474
DOI:10.1186/s12891-020-03626-2