gms | German Medical Science

Objectives/Interrogation: An uncertainty exists about what change in PROMIS scores represents a true clinically relevant improvement (minimal clinically important difference [MCID]) in hand surgery care. Using a region-specific PRO tool (Michigan Hand Question (MHQ)) and a condition-specific PRO tool (Boston Carpal Tunnel Questionnaire (BCTQ)) as anchors, MCID values were determined for PROMIS PF, UE, and PI among patients undergoing carpal tunnel release (CTR).

Methods: Patients undergoing carpal tunnel release with a single surgeon from November 2014 to April 2017 were asked to complete the BCTQ, MHQ and PROMIS PF, UE, and PI CAT at each visit. Patients who had completed questionnaires both at a preoperative and either a six-week or three-month postoperative visit were included. MCID values were calculated using established methods in the literature with both region- (i.e., MHQ) and condition-specific (i.e., BCTQ) PRO tool anchors. The region-specific anchor was the MHQ Satisfaction domain, while the condition-specific anchor was the average score of the two BCTQ domains.

Results and Conclusions: A total of 70 patients fit our inclusion criteria. The average age was 61 years (range, 27-86 years) and a minority were men (34.3%). Of our sample, 43 patients (61.4%) had a six-week follow-up, while 27 patients (38.6%) had a three-month follow-up. Using MHQ Satisfaction, PROMIS UE and PI MCIDs were 4.60 and -3.90, respectively; PROMIS PF could not be calculated. Using the average of the two BCTQ domains, PROMIS PF, UE, and PI MCIDs were 2.45, 3.50, and -3.90, respectively.

PROMIS UE and PI can be used to determine MCID cut-offs similarly to both region- and condition-specific PRO tools for patients undergoing CTR. PROMIS PF does not perform as well.