Skip to main content
. 2010 Aug 25;21(1):100–119. doi: 10.1007/s10926-010-9260-6

Table 2.

Quality measures: measure titles, ratings, and evidence level*

Measure title Validity Feasibility Importance Evidence
Median N (%) of Ratings >=7 Median N (%) of Ratings >=4 Median level
Initial evaluation of hand and forearm symptoms
1. New symptoms characteristic of CTS require detailed assessment 8 (2–9) 9 (82%) 8 (7–9) 11 (100%) 8 (6–9) 2
2. New symptoms characteristic of CTS should lead to suspicion 8 (7–9) 11 (100%) 8 (7–9) 11 (100%) 7 (5–8) 2
3. New hand or forearm pain requires evaluation for “red flags” 8 (1–9) 10 (91%) 8 (1–9) 10 (91%) 8 (1–9) 3
4. Symptoms inconsistent with CTS require evaluation 8 (6–9) 10 (91%) 8 (4–9) 11 (100%) 8 (5–9) 3
5. New CTS diagnosis requires assessment of medical risk factors 8 (1–9) 9 (82%) 8 (7–9) 11 (100%) 8 (5–9) 3
6. New suspicion of CTS requires specific physical examination 8 (5–9) 10 (91%) 8 (4–9) 11 (100%) 8 (5–9) 2
7. New suspicion of CTS requires evaluation for overweight 7 (5–9) 9 (82%) 7 (7–9) 11 (100%) 6 (2–9) 3
8. Imaging should be used selectively for suspected CTS 8 (7–9) 11 (100%) 8 (8–9) 11 (100%) 7 (3–9) 3
9. Symptoms should be monitored after new diagnosis of CTS 8 (7–8) 11 (100%) 8 (7–9) 11 (100%) 7 (4–8) 3
Non-operative treatment of CTS
10. Splints should be placed in neutral position 8 (7–9) 11 (100%) 8 (5–9) 11 (100%) 7 (4–9) 1
11. An attempt at splinting should last at least six weeks 7 (1–8) 8 (73%) 7 (1–8) 11 (100%) 7 (1–8) 1
Certain medications should not be used for CTS
12. NSAIDs 7 (4–8) 9 (82%) 7 (6–9) 11 (100%) 7 (3–9) 1
13. Muscle Relaxants 7 (6–9) 10 (91%) 8 (6–9) 11 (100%) 7 (3–9) 3
14. Opioids 8 (7–9) 11 (100%) 8 (7–9) 11 (100%) 7 (3–9) 3
15. Diuretics 8 (2–9) 11 (100%) 8 (7–9) 11 (100%) 7 (2–9) 1
16. Lasers should not be used for CTS 8 (7–9) 11 (100%) 8 (3–9) 10 (91%) 7 (1–9) 1
17. Discuss benefits of surgery when offering steroids to patients with severe CTS 8 (6–8) 10 (91%) 8 (6–9) 11 (100%) 8 (5–8) 1
18. Steroid treatment requires discussion of risks 8 (6–9) 10 (91%) 8 (7–9) 11 (100%) 6 (3–9) 3
19. Steroids for work-associated symptoms require follow-up 7 (6–9) 10 (91%) 8 (7–9) 11 (100%) 7 (5–9) 3
20. Limit steroid injections to 4 7 (4–9) 10 (91%) 8 (5–9) 11 (100%) 7 (3–9) 3
Addressing activities and functional limitations potentially associated with CTS symptoms
21. New CTS diagnosis requires detailed occupational history 7 (2–9) 9 (82%) 7 (7–9) 11 (100%) 6 (2–9) 3
22. New CTS diagnosis requires assessment of occupational factors 7 (5–9) 8 (73%) 8 (5–9) 11 (100%) 7 (5–9) 2
23. New CTS diagnosis requires assessment of non-occupational factors 7 (5–9) 8 (73%) 8 (5–9) 11 (100%) 7 (5–9) 2
24. Exacerbating activities should be identified when CTS limits functioning 7 (4–9) 6 (55%) 7 (6–9) 11 (100%) 7 (5–9) 3
25. Rationale for work-association should be documented 7 (4–8) 6 (55%) 6 (3–8) 9 (82%) 7 (4–9) 3
26. Patients diagnosed with CTS should be educated about the condition 7 (5–9) 6 (55%) 7 (4–9) 11 (100%) 7 (5–9) 3
27. Exposures to vibration, force, and repetition should be minimized 7 (3–9) 7 (64%) 7 (4–8) 11 (100%) 7 (4–9) 2–3
28. Work-associated CTS symptoms require prompt follow-up 8 (6–9) 10 (91%) 8 (5–9) 11 (100%) 8 (2–9) 3
29. Work status should be monitored when CTS appears work associated 7 (5–9) 9 (82%) 7 (5–9) 11 (100%) 7 (5–9) 3
30. Return to work after CTS-related disability requires follow-up assessment 7 (5–9) 6 (55%) 7 (6–9) 11 (100%) 6 (5–9) 3
31. Prolonged CTS-related disability should trigger evaluation 7 (6–9) 10 (91%) 7 (6–9) 11 (100%) 7 (6–9) 2–3

* The table lists measure titles. The actual text of the measures is provided in Table 1

Validity Ratings >=7 indicated panelists thought the measure was valid. Feasibility Ratings >=4 indicated panelists thought the measure was potentially feasible. Level of Evidence: 1 = randomized controlled trial, 2 = observational data, 3 = case series or expert consensus