Measuring symptoms severity in carpal tunnel syndrome : score agreement and responsiveness of the Atroshi-Lyrén 6-item symptoms scale and the Boston symptom severity scale
(2022) In Quality of Life Research 31(5). p.1553-1560- Abstract
Purpose: To assess score agreement between the Atroshi-Lyrén 6-item symptoms scale and the Boston 11-item symptom severity scale and compare their responsiveness in patients with carpal tunnel syndrome before and after carpal tunnel release surgery. Methods: This prospective cohort study included 3 cohorts that completed the A-L and Boston scales (conventional score 1–5) on the same occasion: a preoperative and short-term postoperative cohort (212 patients), a mid-term postoperative cohort (101 patients), and a long-term postoperative cohort (124 patients). Agreement was assessed with Lin’s concordance correlation coefficient and Passing-Bablok regression analysis. Analyses using item response theory were conducted on responses from the... (More)
Purpose: To assess score agreement between the Atroshi-Lyrén 6-item symptoms scale and the Boston 11-item symptom severity scale and compare their responsiveness in patients with carpal tunnel syndrome before and after carpal tunnel release surgery. Methods: This prospective cohort study included 3 cohorts that completed the A-L and Boston scales (conventional score 1–5) on the same occasion: a preoperative and short-term postoperative cohort (212 patients), a mid-term postoperative cohort (101 patients), and a long-term postoperative cohort (124 patients). Agreement was assessed with Lin’s concordance correlation coefficient and Passing-Bablok regression analysis. Analyses using item response theory were conducted on responses from the preoperative/short-term postoperative cohort including testing of item infit/outfit. Reliability was assessed with Cronbach alpha. Overall and sex-specific effect sizes were calculated using Cohen’s d. Results: Lin’s CCCs were high (0.81–0.91). Passing-Bablok analysis showed constant and proportional differences in all cohorts except preoperative to short-term postoperative change. Both scales showed high reliability (alpha, 0.88–0.93). The IRT-based analyses showed infit/outfit values within the desired range. With IRT-based scoring, the A-L scale had significantly higher responsiveness than the Boston scale, overall (d, 2.02 vs 1.59), in women (d, 2.22 vs 1.77) and in men (d, 1.74 vs 1.36). Conclusion: The Atroshi-Lyrén 6-item symptoms scale and the Boston 11-item symptom severity scale show good agreement but are not equivalent in measuring CTS-related symptoms severity. When using IRT-based scoring, the Atroshi-Lyrén scale demonstrated significantly higher responsiveness.
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- author
- Möllestam, Kamelia LU ; Rosales, Roberto S. ; Lyrén, Per Erik and Atroshi, Isam LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Carpal tunnel release surgery, Carpal tunnel syndrome, Item response theory, Patient-reported outcome measures, Symptom severity scale
- in
- Quality of Life Research
- volume
- 31
- issue
- 5
- pages
- 1553 - 1560
- publisher
- Springer
- external identifiers
-
- scopus:85120605098
- pmid:34800220
- ISSN
- 0962-9343
- DOI
- 10.1007/s11136-021-03039-1
- language
- English
- LU publication?
- yes
- id
- d5a4266e-3e0e-48a0-8dfe-63315c66a58c
- date added to LUP
- 2022-01-18 11:41:03
- date last changed
- 2024-04-20 19:03:13
@article{d5a4266e-3e0e-48a0-8dfe-63315c66a58c,
abstract = {{<p>Purpose: To assess score agreement between the Atroshi-Lyrén 6-item symptoms scale and the Boston 11-item symptom severity scale and compare their responsiveness in patients with carpal tunnel syndrome before and after carpal tunnel release surgery. Methods: This prospective cohort study included 3 cohorts that completed the A-L and Boston scales (conventional score 1–5) on the same occasion: a preoperative and short-term postoperative cohort (212 patients), a mid-term postoperative cohort (101 patients), and a long-term postoperative cohort (124 patients). Agreement was assessed with Lin’s concordance correlation coefficient and Passing-Bablok regression analysis. Analyses using item response theory were conducted on responses from the preoperative/short-term postoperative cohort including testing of item infit/outfit. Reliability was assessed with Cronbach alpha. Overall and sex-specific effect sizes were calculated using Cohen’s d. Results: Lin’s CCCs were high (0.81–0.91). Passing-Bablok analysis showed constant and proportional differences in all cohorts except preoperative to short-term postoperative change. Both scales showed high reliability (alpha, 0.88–0.93). The IRT-based analyses showed infit/outfit values within the desired range. With IRT-based scoring, the A-L scale had significantly higher responsiveness than the Boston scale, overall (d, 2.02 vs 1.59), in women (d, 2.22 vs 1.77) and in men (d, 1.74 vs 1.36). Conclusion: The Atroshi-Lyrén 6-item symptoms scale and the Boston 11-item symptom severity scale show good agreement but are not equivalent in measuring CTS-related symptoms severity. When using IRT-based scoring, the Atroshi-Lyrén scale demonstrated significantly higher responsiveness.</p>}},
author = {{Möllestam, Kamelia and Rosales, Roberto S. and Lyrén, Per Erik and Atroshi, Isam}},
issn = {{0962-9343}},
keywords = {{Carpal tunnel release surgery; Carpal tunnel syndrome; Item response theory; Patient-reported outcome measures; Symptom severity scale}},
language = {{eng}},
number = {{5}},
pages = {{1553--1560}},
publisher = {{Springer}},
series = {{Quality of Life Research}},
title = {{Measuring symptoms severity in carpal tunnel syndrome : score agreement and responsiveness of the Atroshi-Lyrén 6-item symptoms scale and the Boston symptom severity scale}},
url = {{http://dx.doi.org/10.1007/s11136-021-03039-1}},
doi = {{10.1007/s11136-021-03039-1}},
volume = {{31}},
year = {{2022}},
}