Teryl K Nuckols1,2, Craig Conlon3, Michael Robbins1, Michael Dworsky1, Julie Lai1, Carol P Roth1, Barbara Levitan1, Seth Seabury4, Rachana Seelam1, Douglas Benner5, Steven M Asch1,6,7. 1. RAND Corporation, 1776 Main Street Santa Monica, California, 90407, USA. 2. Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA. 3. Employee Health, The Permanente Medical Group, Oakland, California, USA. 4. University of Southern California, USC Schaeffer Center, Los Angeles, California, USA. 5. EK Health Inc, San Jose, California, USA. 6. VA Palo Alto Health Care System, Menlo Park, California, USA. 7. Division of General Medical Disciplines, Stanford University School of Medicine, Palo Alto, California, USA.
Abstract
INTRODUCTION: Higher quality care for carpal tunnel syndrome (CTS) may be associated with better outcomes. METHODS: This prospective observational study recruited adults diagnosed with CTS from 30 occupational health centers, evaluated physicians' adherence to recommended care processes, and assessed results of the Boston Carpal Tunnel Questionnaire (BCTQ) and Short Form Health Survey version 2 (SF-12v2) at recruitment and at 18 months. RESULTS: Among 343 individuals, receiving better care (80th vs. 20th percentile for adherence) was associated with greater improvements in BCTQ Symptom Severity scores (-0.18, 95% confidence interval [CI] -0.32 to -0.05), BCTQ Functional Status scores (-0.21, 95% CI -0.34 to -0.08), and SF12-v2 Physical Component scores (1.75, 95% CI 0.33-3.16). Symptoms improved more when physicians assessed and managed activity, patients underwent necessary surgery, and employers adjusted job tasks. DISCUSSION: Efforts should be made to ensure that patients with CTS receive essential care processes including necessary surgery and activity assessment and management. Muscle Nerve 57: 896-904, 2018.
INTRODUCTION: Higher quality care for carpal tunnel syndrome (CTS) may be associated with better outcomes. METHODS: This prospective observational study recruited adults diagnosed with CTS from 30 occupational health centers, evaluated physicians' adherence to recommended care processes, and assessed results of the Boston Carpal Tunnel Questionnaire (BCTQ) and Short Form Health Survey version 2 (SF-12v2) at recruitment and at 18 months. RESULTS: Among 343 individuals, receiving better care (80th vs. 20th percentile for adherence) was associated with greater improvements in BCTQ Symptom Severity scores (-0.18, 95% confidence interval [CI] -0.32 to -0.05), BCTQ Functional Status scores (-0.21, 95% CI -0.34 to -0.08), and SF12-v2 Physical Component scores (1.75, 95% CI 0.33-3.16). Symptoms improved more when physicians assessed and managed activity, patients underwent necessary surgery, and employers adjusted job tasks. DISCUSSION: Efforts should be made to ensure that patients with CTS receive essential care processes including necessary surgery and activity assessment and management. Muscle Nerve 57: 896-904, 2018.
Authors: Elizabeth A McGlynn; Steven M Asch; John Adams; Joan Keesey; Jennifer Hicks; Alison DeCristofaro; Eve A Kerr Journal: N Engl J Med Date: 2003-06-26 Impact factor: 91.245
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Authors: Benjamin C Amick; Rochelle V Habeck; Janet Ossmann; Anne H Fossel; Robert Keller; Jeffrey N Katz Journal: J Occup Environ Med Date: 2004-05 Impact factor: 2.162