|Title:||Clinical course, costs and predictive factors for response to treatment in carpal tunnel syndrome: The PALMS study|
|Project Description:||Carpal tunnel syndrome is the commonest neuropathy of the upper limb and a significant contributor to hand functional impairment and disability. Effective treatment options include conservative and surgical interventions, however it is not possible at present to predict the outcome of treatment. The primary aim of this study is to identify which baseline clinical factors predict a good outcome from conservative treatment by injection or surgery in patients diagnosed with carpal tunnel syndrome. Secondary aims are to describe the clinical course and progression of CTS, and to describe and predict the cost of CTS to the individual, NHS and society over a two year period.
In this prospective observational cohort study patients presenting with clinical signs and symptoms typical of CTS and in whom the diagnosis is confirmed by nerve conduction studies are invited to participate. Data on putative predictive factors are collected at baseline and follow-up through patient questionnaires and include standardised measures of symptom severity, hand function, psychological and physical health and quality of life. Resource use and cost over the 2 year period such as prescribed medications, primary, secondary and tertiary NHS and private healthcare are also collected through patient self-report at 6, 12, 18 and 24 months. The primary outcome used to classify treatment success or failures will be a 5-point global assessment of change. Secondary outcomes include changes in clinical symptoms, functioning, psychological health, quality of life and resource use. A multivariable model of factors which predict outcome and resource use will be developed.
This prospective cohort study will provide important data on the clinical course and costs of CTS over a two-year period and begin to identify predictive factors for treatment success from conservative and surgical interventions.
|Start date:||1st April 2013|
|End date:||31st March 2016|
|Contact person:||Dr Ed Wilson|
|Contact Details:||Primary Care Unit
Institute of Public Health
University Forvie Site, Robinson Way
Fax: 01223 762515
|Collaborative:||Christina Jerosch-Herold, Lee Shepstone, Tony Dyer, Julian Blake|
|Further Information, References and Publications|
|Led by Dr Christina Jerosch-Herold at UEA, economists from the HSR group are leading the economic component of this study.|