Carpal TunnelNCT03532373
Testing of a Tool to Elicit Patient Preferences for CTS
A study testing Preference Elicitation tool in people with Carpal Tunnel and Carpal Tunnel Syndrome, run by Stanford University at 1 site in United States.
Trial summary
This study will complete a randomized controlled trial to quantitatively measure patient decisional conflict (Decisional Conflict Scale) in 150 patients treated for CTS with the tool compared to 150 patients treated with standard care. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Carpal Tunnel, Carpal Tunnel Syndrome, Carpal Tunnel Syndrome Left
- What is being tested?
- Preference Elicitation tool
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 49 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Mar 2021to 1 Jun 2023
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- New patient
- English fluency and literacy
- Able to take informed consent
- clinical diagnosis of carpal tunnel syndrome
Who cannot join
- Prior diagnostic testing for carpal tunnel (nerve test, ultrasound)
- Prior carpal tunnel release
- Diagnosis of C5/6 radiculopathy (double crush)
- Peripheral neuropathy (ex: diabetic)
- Worker Compensation/EMG Required
- Symptoms of Cubital tunnel syndrome
Trial locations and contacts
1 site in 1 country.
United States1 site
Stanford Health Care
Redwood City, California, 94061
About this study
This study will complete a randomized controlled trial to quantitatively measure patient decisional conflict (Decisional Conflict Scale) in 150 patients treated for CTS with the tool compared to 150 patients treated with standard care. The investigators hypothesize patients treated for CTS will have lower decisional conflict with the tool.
Read the detailed description
The investigators will measure decisional conflict in 150 new patients being evaluated for CTS with the tool compared to 150 patients being evaluated for CTS with standard care. Those patients randomized to receiving the tool will use it to identify their preferences for certain attributes of care. Patients will then be presented with their preference data and the surgeon will have a discussion with the patient regarding CTS. Surgeons will have their standard discussion with the patients randomized to the standard care group (no tool). The tool will be operationalized on a Health Insurance Portability and Accountability Act compliant data platform, such as Qualtrics, and no identifiable data will be collected. De-identified data will be shared from study cites with our team at Stanford. This data will be backed up on a computer encrypted by Stanford.
- Conditions
- Carpal Tunnel, Carpal Tunnel Syndrome, Carpal Tunnel Syndrome Left, Carpal Tunnel Syndrome Right, Carpal Tunnel Syndrome Bilateral
- Being tested
- Preference Elicitation tool
- Medical subject headings
- Median Neuropathy, Carpal Tunnel Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Preference Elicitation toolOther
A preference elicitation tool for carpal tunnel syndrome
| Study group | Role | What they receive |
|---|---|---|
| Control | No intervention | None- normal care |
| Intervention | Experimental | Patients will use a preference elicitation tool to determine their preferences for diagnosis and treatment of CTS Receives: Other: Preference Elicitation tool |
What is being measured
The primary outcome is the main question the study is designed to answer.
Decisional Conflict Scale
The Decisional Conflict Scale measures uncertainty in choosing options; modifiable factors contributing to uncertainty such as feeling uninformed, unclear about personal values and unsupported in decision making; and effective decision making such as feeling the choice is informed, values-based, likely to be implemented and expressing satisfaction with the choice. The survey consists of 16 statements with 5 response categories. Scoring: total scale-0 (no decisional conflict) to 100 (extreme decisional conflict). Lower values indicate lower decisional conflict- i.e. a better outcome for use of the tool. Calculation: Summed, divided by # of items, multiplied by 25
Measured: Immediately after using tool (up to 5 minutes to complete survey)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 May 2018
- Study start1 Mar 2021
- Primary completion1 Jun 2023
- Study completion1 Jun 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (25)Papers the sponsor has linked to this study.
- Other trials for Carpal TunnelStudies of the same condition, open and under way.
- More trials run by Stanford UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants are randomly assigned to either the intervention or control group
- Masking
- None (open label)
- Enrolment
- 49 participants (actual)
Sponsor and investigators
- Lead sponsor
- Stanford University
- Sponsor type
- University, hospital or other
- Collaborators
- Duke University, Brown University, University of Texas at Austin, Mayo Clinic, Harvard University, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
- Responsible party
- Principal investigator, Robin Kamal, Stanford University
- Investigators
- Robin N Kamal, MD, Principal investigator, Stanford University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03532373
- Sponsor's protocol ID
- 46107
- Other IDs
- K23AR073307
- Status last verified
- Jun 2024
- First submitted
- 9 May 2018
- Last updated
- 3 Jul 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: IPD will not be shared with other researchers
Publications
Zhang S, Vora M, Harris AH, Baker L, Curtin C, Kamal RN. Cost-Minimization Analysis of Open and Endoscopic Carpal Tunnel Release. J Bone Joint Surg Am. 2016 Dec 7;98(23):1970-1977. doi: 10.2106/JBJS.16.00121.
PubMed 27926678Atroshi I, Englund M, Turkiewicz A, Tagil M, Petersson IF. Incidence of physician-diagnosed carpal tunnel syndrome in the general population. Arch Intern Med. 2011 May 23;171(10):943-4. doi: 10.1001/archinternmed.2011.203. No abstract available.
PubMed 21606100Fajardo M, Kim SH, Szabo RM. Incidence of carpal tunnel release: trends and implications within the United States ambulatory care setting. J Hand Surg Am. 2012 Aug;37(8):1599-605. doi: 10.1016/j.jhsa.2012.04.035. Epub 2012 Jun 23.
PubMed 22727925Hageman MG, Kinaci A, Ju K, Guitton TG, Mudgal CS, Ring D; Science of Variation Group. Carpal tunnel syndrome: assessment of surgeon and patient preferences and priorities for decision-making. J Hand Surg Am. 2014 Sep;39(9):1799-1804.e1. doi: 10.1016/j.jhsa.2014.05.035. Epub 2014 Aug 1.
PubMed 25087865Oshima Lee E, Emanuel EJ. Shared decision making to improve care and reduce costs. N Engl J Med. 2013 Jan 3;368(1):6-8. doi: 10.1056/NEJMp1209500. No abstract available.
PubMed 23281971Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, Cording E, Tomson D, Dodd C, Rollnick S, Edwards A, Barry M. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012 Oct;27(10):1361-7. doi: 10.1007/s11606-012-2077-6. Epub 2012 May 23.
PubMed 22618581Alfandre D. Clinical Recommendations in Medical Practice: A Proposed Framework to Reduce Bias and Improve the Quality of Medical Decisions. J Clin Ethics. 2016 Spring;27(1):21-7.
PubMed 27045301Mulley AG, Trimble C, Elwyn G. Stop the silent misdiagnosis: patients' preferences matter. BMJ. 2012 Nov 8;345:e6572. doi: 10.1136/bmj.e6572. No abstract available.
PubMed 23137819Lang F, Floyd MR, Beine KL. Clues to patients' explanations and concerns about their illnesses. A call for active listening. Arch Fam Med. 2000 Mar;9(3):222-7. doi: 10.1001/archfami.9.3.222.
PubMed 10728107Johnson DC, Mueller DE, Deal AM, Dunn MW, Smith AB, Woods ME, Wallen EM, Pruthi RS, Nielsen ME. Integrating Patient Preference into Treatment Decisions for Men with Prostate Cancer at the Point of Care. J Urol. 2016 Dec;196(6):1640-1644. doi: 10.1016/j.juro.2016.06.082. Epub 2016 Jun 23.
PubMed 27346032Fraenkel L, Chodkowski D, Lim J, Garcia-Tsao G. Patients' preferences for treatment of hepatitis C. Med Decis Making. 2010 Jan-Feb;30(1):45-57. doi: 10.1177/0272989X09341588. Epub 2009 Jul 27.
PubMed 19636065Hageman MG, Bossen JK, Neuhaus V, Mudgal CS, Ring D; Science of Variation Group. Assessment of Decisional Conflict about the Treatment of carpal tunnel syndrome, Comparing Patients and Physicians. Arch Bone Jt Surg. 2016 Apr;4(2):150-5.
PubMed 27200394Kamal RN; Hand Surgery Quality Consortium. Quality and Value in an Evolving Health Care Landscape. J Hand Surg Am. 2016 Jul;41(7):794-9. doi: 10.1016/j.jhsa.2016.05.016.
PubMed 27374791Keith MW, Masear V, Amadio PC, Andary M, Barth RW, Graham B, Chung K, Maupin K, Watters WC 3rd, Haralson RH 3rd, Turkelson CM, Wies JL, McGowan R. Treatment of carpal tunnel syndrome. J Am Acad Orthop Surg. 2009 Jun;17(6):397-405. doi: 10.5435/00124635-200906000-00008.
PubMed 19474449Newington L, Harris EC, Walker-Bone K. Carpal tunnel syndrome and work. Best Pract Res Clin Rheumatol. 2015 Jun;29(3):440-53. doi: 10.1016/j.berh.2015.04.026. Epub 2015 May 27.
PubMed 26612240
Study at a glance
From the registry record, last updated by the sponsor on 3 Jul 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Testing of a Tool to Elicit Patient Preferences for CTS
- ClinicalTrials.gov ID
- NCT03532373
- Acronym / sponsor ID
- 46107
- Conditions
- Carpal Tunnel, Carpal Tunnel Syndrome, Carpal Tunnel Syndrome Left, Carpal Tunnel Syndrome Right, Carpal Tunnel Syndrome Bilateral
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 49 participants (actual)
- Lead sponsor
- Stanford UniversityUniversity, hospital or other
- Collaborators
- Duke University, Brown University, University of Texas at Austin, Mayo Clinic, Harvard University, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
- Study start
- 1 Mar 2021 (actual)
- Primary completion
- 1 Jun 2023 (actual)
- Study completion
- 1 Jun 2023 (actual)
- First posted
- 22 May 2018 (actual)
- Results
- Posted 3 Jul 2024
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will complete a randomized controlled trial to quantitatively measure patient decisional conflict (Decisional Conflict Scale) in 150 patients treated for CTS with the tool compared to 150 patients treated with standard care. The investigators hypothesize patients treated for CTS will have lower decisional conflict with the tool.
Detailed description
The investigators will measure decisional conflict in 150 new patients being evaluated for CTS with the tool compared to 150 patients being evaluated for CTS with standard care. Those patients randomized to receiving the tool will use it to identify their preferences for certain attributes of care. Patients will then be presented with their preference data and the surgeon will have a discussion with the patient regarding CTS. Surgeons will have their standard discussion with the patients randomized to the standard care group (no tool). The tool will be operationalized on a Health Insurance Portability and Accountability Act compliant data platform, such as Qualtrics, and no identifiable data will be collected. De-identified data will be shared from study cites with our team at Stanford. This data will be backed up on a computer encrypted by Stanford.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Participants are randomly assigned to either the intervention or control group
| Arm | Type | Receives |
|---|---|---|
| Control | No intervention | –None- normal care |
| Intervention | Experimental | Other: Preference Elicitation toolPatients will use a preference elicitation tool to determine their preferences for diagnosis and treatment of CTS |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- New patient
- English fluency and literacy
- Able to take informed consent
- clinical diagnosis of carpal tunnel syndrome
Key exclusion criteria (6 listed)
- Prior diagnostic testing for carpal tunnel (nerve test, ultrasound)
- Prior carpal tunnel release
- Diagnosis of C5/6 radiculopathy (double crush)
- Peripheral neuropathy (ex: diabetic)
- Worker Compensation/EMG Required
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Preference Elicitation toolA preference elicitation tool for carpal tunnel syndrome | Other | Intervention |
Primary outcome
Decisional Conflict Scale
Time frame: Immediately after using tool (up to 5 minutes to complete survey)
The Decisional Conflict Scale measures uncertainty in choosing options; modifiable factors contributing to uncertainty such as feeling uninformed, unclear about personal values and unsupported in decision making; and effective decision making such as feeling the choice is informed, values-based, likely to be implemented and expressing satisfaction with the choice. The survey consists of 16 statements with 5 response categories. Scoring: total scale-0 (no decisional conflict) to 100 (extreme decisional conflict). Lower values indicate lower decisional conflict- i.e. a better outcome for use of the tool. Calculation: Summed, divided by # of items, multiplied by 25
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Jul 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 27926678Zhang S, Vora M, Harris AH, Baker L, Curtin C, Kamal RN. Cost-Minimization Analysis of Open and Endoscopic Carpal Tunnel Release. J Bone Joint Surg Am. 2016 Dec 7;98(23):1970-1977. doi: 10.2106/JBJS.16.00121.
- Background: PubMed 21606100Atroshi I, Englund M, Turkiewicz A, Tagil M, Petersson IF. Incidence of physician-diagnosed carpal tunnel syndrome in the general population. Arch Intern Med. 2011 May 23;171(10):943-4. doi: 10.1001/archinternmed.2011.203. No abstract available.
- Background: PubMed 22727925Fajardo M, Kim SH, Szabo RM. Incidence of carpal tunnel release: trends and implications within the United States ambulatory care setting. J Hand Surg Am. 2012 Aug;37(8):1599-605. doi: 10.1016/j.jhsa.2012.04.035. Epub 2012 Jun 23.
- Background: PubMed 25087865Hageman MG, Kinaci A, Ju K, Guitton TG, Mudgal CS, Ring D; Science of Variation Group. Carpal tunnel syndrome: assessment of surgeon and patient preferences and priorities for decision-making. J Hand Surg Am. 2014 Sep;39(9):1799-1804.e1. doi: 10.1016/j.jhsa.2014.05.035. Epub 2014 Aug 1.
- Background: PubMed 23281971Oshima Lee E, Emanuel EJ. Shared decision making to improve care and reduce costs. N Engl J Med. 2013 Jan 3;368(1):6-8. doi: 10.1056/NEJMp1209500. No abstract available.
- Background: PubMed 22618581Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, Cording E, Tomson D, Dodd C, Rollnick S, Edwards A, Barry M. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012 Oct;27(10):1361-7. doi: 10.1007/s11606-012-2077-6. Epub 2012 May 23.
- Background: PubMed 27045301Alfandre D. Clinical Recommendations in Medical Practice: A Proposed Framework to Reduce Bias and Improve the Quality of Medical Decisions. J Clin Ethics. 2016 Spring;27(1):21-7.
- Background: PubMed 23137819Mulley AG, Trimble C, Elwyn G. Stop the silent misdiagnosis: patients' preferences matter. BMJ. 2012 Nov 8;345:e6572. doi: 10.1136/bmj.e6572. No abstract available.
- Background: PubMed 10728107Lang F, Floyd MR, Beine KL. Clues to patients' explanations and concerns about their illnesses. A call for active listening. Arch Fam Med. 2000 Mar;9(3):222-7. doi: 10.1001/archfami.9.3.222.
- Background: PubMed 27346032Johnson DC, Mueller DE, Deal AM, Dunn MW, Smith AB, Woods ME, Wallen EM, Pruthi RS, Nielsen ME. Integrating Patient Preference into Treatment Decisions for Men with Prostate Cancer at the Point of Care. J Urol. 2016 Dec;196(6):1640-1644. doi: 10.1016/j.juro.2016.06.082. Epub 2016 Jun 23.
- Background: PubMed 19636065Fraenkel L, Chodkowski D, Lim J, Garcia-Tsao G. Patients' preferences for treatment of hepatitis C. Med Decis Making. 2010 Jan-Feb;30(1):45-57. doi: 10.1177/0272989X09341588. Epub 2009 Jul 27.
- Background: PubMed 27200394Hageman MG, Bossen JK, Neuhaus V, Mudgal CS, Ring D; Science of Variation Group. Assessment of Decisional Conflict about the Treatment of carpal tunnel syndrome, Comparing Patients and Physicians. Arch Bone Jt Surg. 2016 Apr;4(2):150-5.
- Individual participant dataSharing planned: No. IPD will not be shared with other researchers
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Robin N Kamal, MD principal investigator
Stanford University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Preference Elicitation tool in people with Carpal Tunnel and Carpal Tunnel Syndrome, run by Stanford University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 3 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 3 Jul 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Decisional Conflict Scale (time frame: Immediately after using tool (up to 5 minutes to complete survey)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03532373, which also lists 25 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Jul 2024.