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Validation of a Quick CTS-6 Questionnaire for Carpal Tunnel Syndrome
Joydeep Baidya, BS, Gregorio Baek, BS, Evan Johnson, BS, Joshua Pang, BS, Arjun Guthal, BS; Daniel J. Fletcher, M.D.
Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA
Introduction: The CTS-6 questionnaire is used to diagnose carpal tunnel syndrome, but each question carries a different weight for a total of 26 points, which can be a source of inconvenience. The authors hypothesize that a Quick version of the CTS-6 (QCTS-6), where each item is scored uniformly as 0 or 1 for a total of 6 points, would be sufficiently accurate at predicting carpal tunnel syndrome.
Materials and Methods: All patients who underwent carpal tunnel release by the senior author (2017-2024) were retrospectively queried. Preoperative electrodiagnostic study results were collected. CTS-6 questionnaire findings were converted to a score out of 6, where each component was scored 0 if absent or 1 if present. Kruskall-Wallis, Chi-Square, and Spearman's Rho correlations were conducted.
Results: 1143 patients who met inclusion criteria were identified. There was a strong positive relationship between the CTS-6 score and QCTS-6 score for the overall cohort (r=0.976), as well as within each electrodiagnostic severity group (mild: r=0.970; moderate: r=0.975; severe: r=0.975). All CTS-6 domains were found to be more commonly present in the QCTS-6 3+ group. 86.4% of patients with QCTS-6 2+ had CTS-6 12+, which increased to 98.2% at 3+ and 100% at 4 and above. The proportion of patients with severe electrodiagnostic study findings who had QCTS6 2+, 3+, and 4+ were 98.6%, 90.6%, and 73.3%, respectively.
Conclusions: The CTS-6 and QCTS-6 systems demonstrated strong positive correlations both in aggregate, as well as when examined in isolation based on electrodiagnostic severity. Patients with QCTS-6 3+ exhibited high overlap with CTS-6 12+ scores and constituted a large proportion of severe electrodiagnostic findings. The findings of this study indicate that the simplified QCTS-6 system using a cutoff of 3+ can be utilized in clinical practice as a reasonable tool to detect carpal tunnel syndrome without necessitating electrodiagnostic studies.
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