Testing of a Tool to Elicit Patient Preferences for CTS

NCT03532373 | Completed Results

• 2 other identifiers: 46107K23AR073307
• Study Type: interventional
• Target: 49
• Locations: 1 country
• Sites: 1

Brief Summary

This study will complete a randomized controlled trial to quantitatively measure patient decisional conflict (Decisional Conflict Scale) in 150 patients treated for CTS with the tool compared to 150 patients treated with standard care. The investigators hypothesize patients treated for CTS will have lower decisional conflict with the tool.

Conditions

Carpal Tunnel; Carpal Tunnel Syndrome; Carpal Tunnel Syndrome Left; Carpal Tunnel Syndrome Right; Carpal Tunnel Syndrome Bilateral

Outcome Measures

Primary Outcomes (1)

• Decisional Conflict Scale

  The Decisional Conflict Scale measures uncertainty in choosing options; modifiable factors contributing to uncertainty such as feeling uninformed, unclear about personal values and unsupported in decision making; and effective decision making such as feeling the choice is informed, values-based, likely to be implemented and expressing satisfaction with the choice. The survey consists of 16 statements with 5 response categories. Scoring: total scale-0 (no decisional conflict) to 100 (extreme decisional conflict). Lower values indicate lower decisional conflict- i.e. a better outcome for use of the tool. Calculation: Summed, divided by # of items, multiplied by 25

  Immediately after using tool (up to 5 minutes to complete survey)

Study Arms (2)

Control

NO INTERVENTION

None- normal care

Intervention

EXPERIMENTAL

Patients will use a preference elicitation tool to determine their preferences for diagnosis and treatment of CTS

Other: Preference Elicitation tool

Interventions

Preference Elicitation tool OTHER

A preference elicitation tool for carpal tunnel syndrome

Intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• New patient
• English fluency and literacy
• Able to take informed consent
• clinical diagnosis of carpal tunnel syndrome

You may not qualify if:

• Prior diagnostic testing for carpal tunnel (nerve test, ultrasound)
• Prior carpal tunnel release
• Diagnosis of C5/6 radiculopathy (double crush)
• Peripheral neuropathy (ex: diabetic)
• Worker Compensation/EMG Required
• Symptoms of Cubital tunnel syndrome

Sponsors & Collaborators

• Stanford University: lead
• Duke University: collaborator
• Brown University: collaborator
• University of Texas at Austin: collaborator
• Mayo Clinic: collaborator
• Harvard University: collaborator
• National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS): collaborator

Study Sites (1)

Stanford Health Care

Redwood City, California, 94061, United States

Location

Related Publications (25)

• Zhang S, Vora M, Harris AH, Baker L, Curtin C, Kamal RN. Cost-Minimization Analysis of Open and Endoscopic Carpal Tunnel Release. J Bone Joint Surg Am. 2016 Dec 7;98(23):1970-1977. doi: 10.2106/JBJS.16.00121.

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• Atroshi I, Englund M, Turkiewicz A, Tagil M, Petersson IF. Incidence of physician-diagnosed carpal tunnel syndrome in the general population. Arch Intern Med. 2011 May 23;171(10):943-4. doi: 10.1001/archinternmed.2011.203. No abstract available.

  PMID: 21606100 BACKGROUND

• Fajardo M, Kim SH, Szabo RM. Incidence of carpal tunnel release: trends and implications within the United States ambulatory care setting. J Hand Surg Am. 2012 Aug;37(8):1599-605. doi: 10.1016/j.jhsa.2012.04.035. Epub 2012 Jun 23.

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• Hageman MG, Kinaci A, Ju K, Guitton TG, Mudgal CS, Ring D; Science of Variation Group. Carpal tunnel syndrome: assessment of surgeon and patient preferences and priorities for decision-making. J Hand Surg Am. 2014 Sep;39(9):1799-1804.e1. doi: 10.1016/j.jhsa.2014.05.035. Epub 2014 Aug 1.

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• Alfandre D. Clinical Recommendations in Medical Practice: A Proposed Framework to Reduce Bias and Improve the Quality of Medical Decisions. J Clin Ethics. 2016 Spring;27(1):21-7.

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• Mulley AG, Trimble C, Elwyn G. Stop the silent misdiagnosis: patients' preferences matter. BMJ. 2012 Nov 8;345:e6572. doi: 10.1136/bmj.e6572. No abstract available.

  PMID: 23137819 BACKGROUND

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  PMID: 10728107 BACKGROUND

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• Fraenkel L, Chodkowski D, Lim J, Garcia-Tsao G. Patients' preferences for treatment of hepatitis C. Med Decis Making. 2010 Jan-Feb;30(1):45-57. doi: 10.1177/0272989X09341588. Epub 2009 Jul 27.

  PMID: 19636065 BACKGROUND

• Hageman MG, Bossen JK, Neuhaus V, Mudgal CS, Ring D; Science of Variation Group. Assessment of Decisional Conflict about the Treatment of carpal tunnel syndrome, Comparing Patients and Physicians. Arch Bone Jt Surg. 2016 Apr;4(2):150-5.

  PMID: 27200394 BACKGROUND

• Kamal RN; Hand Surgery Quality Consortium. Quality and Value in an Evolving Health Care Landscape. J Hand Surg Am. 2016 Jul;41(7):794-9. doi: 10.1016/j.jhsa.2016.05.016.

  PMID: 27374791 BACKGROUND

• Keith MW, Masear V, Amadio PC, Andary M, Barth RW, Graham B, Chung K, Maupin K, Watters WC 3rd, Haralson RH 3rd, Turkelson CM, Wies JL, McGowan R. Treatment of carpal tunnel syndrome. J Am Acad Orthop Surg. 2009 Jun;17(6):397-405. doi: 10.5435/00124635-200906000-00008.

  PMID: 19474449 BACKGROUND

• Newington L, Harris EC, Walker-Bone K. Carpal tunnel syndrome and work. Best Pract Res Clin Rheumatol. 2015 Jun;29(3):440-53. doi: 10.1016/j.berh.2015.04.026. Epub 2015 May 27.

  PMID: 26612240 BACKGROUND

• Graham B. The value added by electrodiagnostic testing in the diagnosis of carpal tunnel syndrome. J Bone Joint Surg Am. 2008 Dec;90(12):2587-93. doi: 10.2106/JBJS.G.01362.

  PMID: 19047703 BACKGROUND

• Graham B. The diagnosis and treatment of carpal tunnel syndrome. BMJ. 2006 Jun 24;332(7556):1463-4. doi: 10.1136/bmj.332.7556.1463. No abstract available.

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• Pulikkottil BJ, Schub M, Kadow TR, Wang W, Fowler JR. Correlating Median Nerve Cross-sectional Area With Nerve Conduction Studies. J Hand Surg Am. 2016 Oct;41(10):958-962. doi: 10.1016/j.jhsa.2016.08.018.

  PMID: 27702467 BACKGROUND

• Flynn KE, Weinfurt KP, Seils DM, Lin L, Burnett CB, Schulman KA, Meropol NJ. Decisional conflict among patients who accept or decline participation in phase I oncology studies. J Empir Res Hum Res Ethics. 2008 Sep;3(3):69-77. doi: 10.1525/jer.2008.3.3.69.

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• Hyman DJ, Pavlik VN, Greisinger AJ, Chan W, Bayona J, Mansyur C, Simms V, Pool J. Effect of a physician uncertainty reduction intervention on blood pressure in uncontrolled hypertensives--a cluster randomized trial. J Gen Intern Med. 2012 Apr;27(4):413-9. doi: 10.1007/s11606-011-1888-1. Epub 2011 Oct 27.

  PMID: 22033742 BACKGROUND

• Wittink MN, Cary M, Tenhave T, Baron J, Gallo JJ. TOWARDS PATIENT-CENTERED CARE FOR DEPRESSION: CONJOINT METHODS TO TAILOR TREATMENT BASED ON PREFERENCES. Patient. 2010;3(3):145-157. doi: 10.2165/11530660.

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• Baker LC, Bundorf MK, Kessler DP. Patients' preferences explain a small but significant share of regional variation in medicare spending. Health Aff (Millwood). 2014 Jun;33(6):957-63. doi: 10.1377/hlthaff.2013.1184.

  PMID: 24889944 BACKGROUND

• Hampson LA, Allen IE, Gaither TW, Lin T, Ting J, Osterberg EC, Wilson L, Breyer BN. Patient-centered Treatment Decisions for Urethral Stricture: Conjoint Analysis Improves Surgical Decision-making. Urology. 2017 Jan;99:246-253. doi: 10.1016/j.urology.2016.07.053. Epub 2016 Sep 16.

  PMID: 27645527 BACKGROUND

MeSH Terms

Conditions

Median Neuropathy; Carpal Tunnel Syndrome

Condition Hierarchy (Ancestors)

Mononeuropathies; Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Nerve Compression Syndromes; Cumulative Trauma Disorders; Sprains and Strains; Wounds and Injuries

Results Point of Contact

• Title: Robin Kamal
• Organization: Stanford University

rnkamal@stanford.edu

650-721-7629

Study Officials

• Robin N Kamal, MD

  Stanford University

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: No masking will occur
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Model Details: Participants are randomly assigned to either the intervention or control group

Study Record Dates

• First Submitted: May 9, 2018
• First Posted: May 22, 2018
• Study Start: March 1, 2021
• Primary Completion: June 1, 2023
• Study Completion: June 1, 2023
• Last Updated: July 3, 2024
• Results First Posted: July 3, 2024

Record last verified: 2024-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)