Questionnaire Query


Good evening,

I have this evening complete the questionnaire and received back a low score 7% likelihood of CTS.

However I wanted to advise that in the current climate of struggling to see a GP, I have consulted a Pharmacist on 2 occasions when I have a flare up both have mentioned possible Carpal tunnel, I also visited the walk in centre more than 6 months ago again for a similar issue who provided a splint and suggested Carpal Tunnel due to the location of the pain.

Is there a way of including pharmacist in the list as I have marked this up as none of the above as a pharmacist doesn't fall in to the category.

I also found the severity questionnaire a little frustrating, because it is a little hard to answer, I do not suffer pain all the time, this come in spells however the questionnaire doesn't allow for this. For example for the last 3 months I have had no issues, yet last week I was in excruciating pain, unable to use my left wrist/hand or do up my buttons/bra but when filling out the questionnaire today I have very little pain and full use of my hand and fingers.

I understand the reason for the questions and was happy to complete the questionnaire however wonder if it can be modernised slightly to be more time orientate?

I look forward to my follow up. Thanks Chloe


I've had a look at your answers and it really does not sound very like CTS. It is pretty rare in your age group to start off with and when you add to that the fact that it is worse in your non-dominent hand and has not responded at all to a splint it starts to look very unlikely. My guess would be that you actually need to see a hand surgeon. There is a widespread belief that almost any hand symptoms can be attributed to CTS just because it is so common overall but in reality there is quite a wide range of possible diagnoses in the hand with various forms of tendonitis actually being much commoner than CTS in your age group. That is not to say that there is NO possiblity that you have CTS. I have seen it in children occasionally, but the prior evaluation of symptoms by this method allows us to play the odds in directing you to the clinic which is most likely to be able to help. Although I do check the low scoring questionnaires myself and occasionally over-ride the AI evaluation there are a couple of observations to be made:

a) when I do over-ride the website AI - it usually turns out to be right

b) overall the website is more accurate at diagnosisng CTS than -

 any GP I have ever encountered

 any physiotherapist

 most hand surgeons

 me! (when unaided by electrical tests/ultrasound scans etc)

You can probably include pharmacists in this list too :-) It's not that it's never wrong just that if it thinks there is a 10% chance of CTS then roughly nine out of ten patients like that turn out not to have CTS.

The severity questionnaire is mainly used to assess how your answers change over time rather than being an integral part of the diagnostic model so that as long as you are consistent in the way you interpret the questions it makes a valid indicator of whether your are getting worse or better. You can do that bit as often as you like if symptoms are varying.

The last point is that it can't be updated without a colossal amount of work. The AI was trained to recognise CTS based on this particular set of answers and if I change any question or add a new one we would have to build a new model - which would mean having to gather information from as many patients again as it took to build this one - about 5000!

Ask your GP to refer you to a hand surgeon. They should not need to see you for this - just a telephone call would be adequate. JB

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