Summary of findings for the main comparison. Splint versus no treatment for carpal tunnel syndrome.
| Splint versus no treatment for carpal tunnel syndrome | ||||||
| Patient or population: People with carpal tunnel syndrome Settings: Referred for possible carpal tunnel syndrome to EMG laboratory Intervention: Splint versus no treatment | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Splint versus no treatment | |||||
| Short‐term overall improvement (3 months or less) | Study population | RR 3.86 (2.29 to 6.51) | 80 (1 study) | ⊕⊕⊝⊝ low2,3 | ||
| 250 per 10001 | 965 per 1000 (572 to 1000) | |||||
| Adverse effects (difficulty falling asleep) | Study population | RR 7 (0.37 to 131.28) | 80 (1 study) | ⊕⊕⊝⊝ low2,3 | ||
| 0 per 10001 | 0 per 1000 (0 to 0) | |||||
|
Short‐term improvement in CTS symptoms (Levine questionnaire) (3 months or less) Scale: 0 to 5 |
The mean CTS symptom severity score (assessed using the Levine questionnaire) at the end of four weeks of treatment in the control group was 2.611 |
The mean CTS symptom severity score (assessed using the Levine questionnaire) at the end of four weeks of treatment in the intervention group was 1.07 lower4 (1.29 to 0.85 lower) | 80 (1 study) | ⊕⊕⊝⊝ low2,3 | ||
|
Short‐term improvement in functional status (Levine questionnaire) (3 months or less) Scale: 0 to 5 |
The mean functional status score (assessed using the Levine questionnaire) at the end of four weeks of treatment in the control group was 2.031 |
The mean functional status score (assessed using the Levine questionnaire) at the end of four weeks of treatment in the intervention group was 0.55 lower4 (0.82 to 0.28 lower) | 80 (1 study) | ⊕⊕⊝⊝ low2,3 | ||
| Short‐term improvement in distal motor latency (ms) (3 months or less) | The mean short‐term improvement in distal motor latency at the end of four weeks of treatment in the control group was 4.47 ms1 |
The mean short‐term improvement in distal motor latency at the end of four weeks of treatment in the intervention group was 0.02 ms shorter5 (0.49 ms shorter to 0.45 ms longer) | 80 (1 study) | ⊕⊕⊝⊝ low2,3 | ||
| Short‐term improvement in sensory nerve conduction velocity (m/s) (3 months or less) | The mean short‐term improvement in sensory nerve conduction velocity at the end of four weeks of treatment in the control group was 37.92 m/s1 |
The mean short‐term improvement in sensory nerve conduction velocity at the end of four weeks of treatment in the intervention group was 0.72 m/s faster6 (5.85 m/s faster to 4.41 m/s slower) | 80 (1) | ⊕⊕⊝⊝ low2,3 | ||
| Short‐term improvement in sensory nerve action potential (µV) (3 months or less) | The mean short‐term improvement in sensory nerve action potential at the end of four weeks of treatment in the control group was 12.44 µV1 |
The mean short‐term improvement in sensory nerve action potential at the end of four weeks of treatment in the intervention group was 6.3 µV larger7 (0.6 to 12 larger) | 80 (1) | ⊕⊕⊝⊝ low2,3 | ||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Assumed risk is based on the risk in the control group in the study conducted by Manente 2001
2 It was not clear if the allocation sequence was concealed, and participants, personnel and outcome assessors were not blind to treatment allocation 3 Participants only wore splint at night. The effect of full‐time or daytime splint‐wearing versus no treatment has not been investigated
4 Lower scores denote better outcome
5 Shorter latency denotes better outcome
6 Faster conduction velocity denotes better outcome
7 Larger action potential denotes better outcome