Appropriateness of Carpal Tunnel Syndrome Management Compared With the AAOS Appropriate Use Criteria

Carpal Tunnel Syndrome Clinical Trial

— CTS  

Official title:

Appropriateness of Carpal Tunnel Syndrome Management Compared With the AAOS Appropriate Use Criteria: A Retrospective Review Across Various Specialties

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05275816
• Other study ID #: MRC-01-22-085
• Status: Not yet recruiting
• Start date: March 2022
• Est. completion date: August 2022

Study information

• Verified date: March 2022
• Source: Hamad Medical Corporation
• Contact: Loay Salman, MBBS, MSc
• Phone: 0097470000262
• Email: LSalman2[@]hamad.qa
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Purpose: Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disorder among adults that causes upper-extremity disability. The American Academy of Orthopedic Surgeons (AAOS) developed an evidence-based appropriate use criteria (AUC) for the management of CTS. This study aims to assess the appropriateness of our practice and the usability of the AUC by comparing the actual management provided at our institution with that recommended by the AUC. Methods: A retrospective review of the electronic medical records at our hospital will be performed between 1 Jan 2016 and 31 Dec 2019. Data will be collected by two authors independently. The collected data will be input into the AUC application to determine the rate of the appropriateness of the treatments. Afterwards, the agreement between the actual treatment provided and the AUC recommendation will be assessed. The primary outcome will be the appropriateness rate. Descriptive statistics such as the mean, range and percentage will be used to summarize the patients' demographics and treatment options. Results: The appropriateness rating (appropriate, maybe, or rarely appropriate) for each treatment will be described with percentages. Similarly, the agreement of the treatments implemented at our institution with the AUC recommendations will be expressed as a proportion. A subgroup analysis within the same cohort compared the appropriateness rates of surgical release of patients across different surgical specialties using chi2 test. Conclusion: This study will show if the management provided at our institution were appropriate and in agreement with the AUC recommendations. Additionally, it will test the usability of AUC for carpal tunnel syndrome as a valuable and practical tool that can be applied in clinical settings.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 136
• Est. completion date: August 2022
• Est. primary completion date: May 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Adult patients (= 18 years) who were diagnosed with CTS.

Exclusion Criteria as per the AUC:

• Acute carpal tunnel syndrome
• Untreated inflammatory arthritis
• Untreated diabetes
• Thyroid disease
• Pernicious Anemia
• Patients with a known space-occupying lesion in the carpal tunnel
• Failed treatment after surgery
• Pediatric and adolescent patients

Related Conditions & MeSH terms

• Carpal Tunnel Syndrome
• Syndrome

Intervention

Other:
• Comparing the appropriateness of our practice and the usability of the AUC through comparing the actual management provided at our institution with that recommended by the AUC.
The AUC application for carpal tunnel syndrome management requires four patients' variables to generate appropriateness ratings for six different treatment options. Each procedure is rated as appropriate, maybe appropriate, or rarely appropriate. The six procedures include splint, steroid injection, carpal tunnel release, oral steroids or Ketoprofen phonophoresis, investigation of alternative diagnoses, and further investigation using an electro-diagnostic study. To judge the usability of the AUC for the management of carpal tunnel syndrome, the required parameters of each patient were collected and entered into the AUC application by two independent authors to generate the appropriateness rating of the provided treatment for each patient. Afterwards, the agreement between the AUC recommendations and the actual treatment that was provided at our institution was assessed.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Hamad Medical Corporation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The rate of appropriateness of CTS management in our practice compared to the AUC recommendation	AUC Appropriateness rate (percentage/Continuous outcome): The AUC application for carpal tunnel syndrome management requires four patients' variables to generate appropriateness ratings for six different treatment options. Each procedure is rated as appropriate, maybe appropriate, or rarely appropriate. The six procedures include splint, steroid injection, carpal tunnel release, oral steroids or Ketoprofen phonophoresis, investigation of alternative diagnoses, and further investigation using an electro-diagnostic study.; To judge the appropriateness of the AUC for the management of carpal tunnel syndrome, the required parameters of each patient were collected and entered into the AUC application by two independent authors to generate the appropriateness rating of the provided treatment for each patient. Afterwards, the agreement between the AUC recommendations and the actual treatment that was provided at our institution was assessed.	4 months