Use of a remote assessment pathway for diagnosis of carpal tunnel syndrome

• Published in: The Journal of hand surgery, European volume European volume, 2024-08, p.17531934241270347
• Main Authors: Macdonald, Katie, Pearson, Hugh, Frew, Georgina H, Rust, Philippa
• Format: Article
• Language: English
• ISSN: 2043-6289; 2043-6289
• DOI: 10.1177/17531934241270347

We undertook a retrospective cohort study of a remote carpal tunnel syndrome assessment pathway created in response to limitations caused by the COVID-19 pandemic. Between July 2020 and September 2021, 702 patients referred from primary care (general practice) were assessed in a nurse-led telephone clinic using the carpal tunnel questionnaire of Kamath and Stothard (2003). Depending on their questionnaire score, patients were referred either for nerve conduction studies or a consultant hand surgeon review for diagnosis and treatment planning. Questionnaire scores of 3 and above accurately predicted a likely diagnosis of carpal tunnel syndrome in 83% of patients, and a diagnosis was unlikely in 90% of those with a score below 3. The pathway resulted in an estimated cost savings of £24,436 (€28,862, US$30,945) in comparison with the pre-pandemic service. However, some limitations in the pathway may have impacted effective patient management and we suggest possible improvements. III.