Minimal Clinically Important Difference and Substantial Clinical Benefit After Carpal Tunnel Release Using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and Mayo Wrist Scores: A Prospective Observational Study

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Abstract
Background Carpal tunnel syndrome is a neuropathic compressive condition caused by median nerve compression as it travels into the wrist through the carpal tunnel. Validated patient-reported outcome measures such as the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and the Mayo Wrist Score are commonly used to assess outcomes following carpal tunnel release; however, limitations remain in interpreting whether observed score changes are clinically meaningful from the patient’s perspective. The primary objective of this study was to determine the minimal clinically important difference (MCID) and substantial clinical benefit (SCB) for the Mayo Wrist Score after isolated carpal tunnel release, and secondarily to contextualize postoperative QuickDASH change using previously reported clinically meaningful thresholds. Methodology This prospective study included adult patients undergoing isolated carpal tunnel release at two tertiary hospitals. QuickDASH and Mayo Wrist Scores were recorded preoperatively and at the six-month follow-up. MCID and SCB were calculated using anchor-based and distribution-based methods, with receiver operating characteristic curve analysis primarily applied to the Mayo Wrist Score. Results A total of 92 patients were enrolled, of whom 73 completed the six-month follow-up. The anchor-based MCID for the Mayo Wrist Score was 11.5 points (area under the curve (AUC) = 0.77), while the SCB threshold was 13.5 points (AUC = 0.91). Significant postoperative improvements were observed in both QuickDASH and Mayo Wrist Scores. Conclusions Establishing MCID and SCB values for the Mayo Wrist Score and contextualizing change in the QuickDASH score provides a clinically meaningful framework for interpreting patient-reported outcomes following carpal tunnel release.

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