{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T08:47:07Z","timestamp":1768466827645,"version":"3.49.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,11,7]],"date-time":"2020-11-07T00:00:00Z","timestamp":1604707200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,11,7]],"date-time":"2020-11-07T00:00:00Z","timestamp":1604707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Health Qual Life Outcomes"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n              <jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Accurate diagnosis of carpal tunnel syndrome (CTS) is essential for directing appropriate treatment; and for making decisions about work injury claims. The Kamath and Stothard Questionnaire (KSQ) is a self-reported tool used for the diagnosis of CTS. Comprehensibility and comprehensiveness of this questionnaire are critical to diagnostic performance and need to be established. The purpose of the study was to describe how potential respondents, clinicians, and measurement researchers interpret KSQ questions in order to identify and resolve potential sources of misclassification.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Hand therapists, measurement researchers, participants with CTS, and a control group were interviewed using cognitive interviewing techniques (talk aloud, semi-structured interview probes) in Hamilton, Canada. All interviews were recorded and transcribed verbatim. A directed content analysis was done to analyze the interviews using a previously established framework.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Findings<\/jats:title>\n                <jats:p>Eighteen participants were interviewed. Areas, where questions were unclear to some participants, were recorded and categorized into five themes: Clarity and Comprehension (52%), Relativeness (38%), Inadequate Response Definition (4%), Perspective Modifiers (4%), and Reference Point (2%). Respondents also identified several symptoms of CTS that are not covered by the KSQ that might be of diagnostic value, e.g., weakness and dropping items.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The content validity of the current iteration of the KSQ was not established. The problematic questions identified in the study have been reported to have low specificity and negative predictive values in a previous quantitative study. The content validity issues identified may explain the poor performance. Recommendations were made to modify the wording of the KSQ and the potential addition of three new questions. Future studies should determine whether the modified questionnaire can provide better diagnostic accuracy and psychometric properties. The results of this study may assist in ruling in or out CTS diagnosis to a wide variety of target audience, such as hand specialists, physical and occupational therapists, as well as family doctors.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12955-020-01614-7","type":"journal-article","created":{"date-parts":[[2020,11,7]],"date-time":"2020-11-07T13:02:38Z","timestamp":1604754158000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Content validation of the Kamath and Stothard questionnaire for carpal tunnel syndrome diagnosis: a cognitive interviewing study"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6581-2980","authenticated-orcid":false,"given":"Armaghan","family":"Dabbagh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joy C.","family":"MacDermid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara L.","family":"Packham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciana G.","family":"Macedo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,11,7]]},"reference":[{"issue":"1","key":"1614_CR1","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.mporth.2013.08.003","volume":"77","author":"RAS Somaiah Aroori","year":"2008","unstructured":"Somaiah Aroori RAS. Carpal tunnel syndrome. Ulster Med J (Internet). 2008;77(1):6\u201317. https:\/\/doi.org\/10.1016\/j.mporth.2013.08.003.","journal-title":"Ulster Med J (Internet)"},{"issue":"11","key":"1614_CR2","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1212\/WNL.58.11.1597","volume":"58","author":"JG Jarvik","year":"2002","unstructured":"Jarvik JG, Yuen E, Haynor DR, Bradley CM, Fulton-Kehoe D, Smith-Weller T, et al. MR nerve imaging in a prospective cohort of patients with suspected carpal tunnel syndrome. Neurology. 2002;58(11):1597\u2013602.","journal-title":"Neurology"},{"issue":"3","key":"1614_CR3","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1046\/j.1445-2197.2002.02347.x","volume":"72","author":"S Falkiner","year":"2002","unstructured":"Falkiner S, Myers S. When exactly can carpal tunnel syndrome be considered work-related? ANZ J Surg (Internet). 2002;72(3):204\u20139.","journal-title":"ANZ J Surg (Internet)"},{"key":"1614_CR4","unstructured":"American Academy of Orthopaedic Surgeons. Management of carpal tunnel syndrome evidence-based clinical practice guideline (Internet); 2016. Available from: www.aaos.org\/ctsguideline."},{"issue":"11","key":"1614_CR5","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1503\/cmaj.131177","volume":"186","author":"V Squissato","year":"2014","unstructured":"Squissato V, Brown G. Carpal tunnel syndrome. CMAJ. 2014;186(11):602\u20135.","journal-title":"CMAJ"},{"key":"1614_CR6","first-page":"1","volume":"20","author":"MS Aboonq","year":"2015","unstructured":"Aboonq MS. Pathophysiology of carpal tunnel syndrome. Neurosciences. 2015;20:1.","journal-title":"Neurosciences"},{"issue":"11","key":"1614_CR7","first-page":"1585","volume":"75","author":"DW Levine","year":"1993","unstructured":"Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. Classic Pap Orthop. 1993;75(11):1585\u201392.","journal-title":"Classic Pap Orthop"},{"issue":"5","key":"1614_CR8","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1016\/S0266-7681(03)00151-7","volume":"28 B","author":"V Kamath","year":"2003","unstructured":"Kamath V, Stothard J. A clinical questionnaire for the diagnosis of carpal tunnel syndrome. J Hand Surg Am (Internet). 2003;28 B(5):455\u20139.","journal-title":"J Hand Surg Am (Internet)"},{"issue":"01","key":"1614_CR9","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1142\/S0218810411005047","volume":"16","author":"MJ Bridges","year":"2010","unstructured":"Bridges MJ, Robertson DC, Chuck AJ. Predicting the result of nerve conduction tests in carpal tunnel syndrome using a questionnaire. Hand Surg. 2010;16(01):39\u201342.","journal-title":"Hand Surg"},{"issue":"3","key":"1614_CR10","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/j.surge.2019.02.001","volume":"17","author":"BS Sangram","year":"2019","unstructured":"Sangram BS, Mayne AIW, Jariwala AC. Can we accurately predict nerve conduction study outcome using a carpal tunnel syndrome questionnaire? Surgeon (Internet). 2019;17(3):156\u20139. https:\/\/doi.org\/10.1016\/j.surge.2019.02.001.","journal-title":"Surgeon (Internet)"},{"key":"1614_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2519\/jospt.2020.9599","volume":"16","author":"A Dabbagh","year":"2020","unstructured":"Dabbagh A, MacDermid JC, Yong J, Macedo LG, Packham TL. Diagnosing carpal tunnel syndrome: diagnostic test accuracy of scales, questionnaires, and hand symptom diagrams\u2014a systematic review. J Orthop Sport Phys Ther (Internet). 2020;16:1\u201347. https:\/\/doi.org\/10.2519\/jospt.2020.9599.","journal-title":"J Orthop Sport Phys Ther (Internet)"},{"issue":"2","key":"1614_CR12","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1177\/0008417417734562","volume":"85","author":"TL Packham","year":"2018","unstructured":"Packham TL, MacDermid JC, Michlovitz SL, Buckley N. Content validation of the Patient-Reported Hamilton Inventory for Complex Regional Pain Syndrome: Validit\u00e9 de contenu du Hamilton Inventory for Complex Regional Pain Syndrome, une mesure des r\u00e9sultats d\u00e9clar\u00e9s par le patient. Can J Occup Ther. 2018;85(2):99\u2013105.","journal-title":"Can J Occup Ther"},{"key":"1614_CR13","first-page":"23","volume":"2004","author":"GB Willis","year":"2004","unstructured":"Willis GB. Cognitive interviewing revisited: a useful technique, in theory? Methods Test Eval Surv Quest. 2004;2004:23\u201343.","journal-title":"Methods Test Eval Surv Quest"},{"key":"1614_CR14","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1002\/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G","volume":"23","author":"M Sandelowski","year":"2000","unstructured":"Sandelowski M. Focus on reseaerch methods: whatever happened to qualitative description? Res Nurs Health. 2000;23:334\u201340.","journal-title":"Res Nurs Health"},{"key":"1614_CR15","first-page":"11","volume":"44","author":"AAM N\u00e1poles-springer","year":"2006","unstructured":"N\u00e1poles-springer AAM, Santoyo-olsson J, Brien HO, Anita L. Using cognitive interviews to develop surveys in diverse populations. Med Care. 2006;44:11.","journal-title":"Med Care."},{"key":"1614_CR16","unstructured":"MacDermid JC. Cognitive interviewing (CI)\u2014to identify sources of interpretation dissonance in in patient-reported outcome measures (PRO). 2018;(Ci):2\u20134."},{"key":"1614_CR17","volume-title":"Stata statistical software: release 14","author":"StataCorp.","year":"2015","unstructured":"StataCorp. Stata statistical software: release 14. College Station: StataCorp LP; 2015."},{"issue":"9","key":"1614_CR18","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1177\/1049732305276687","volume":"15","author":"HF Hsieh","year":"2005","unstructured":"Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277\u201388.","journal-title":"Qual Health Res"},{"key":"1614_CR19","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1002\/nur.20195","volume":"30","author":"K Kathleen","year":"2007","unstructured":"Kathleen K, Janet Deatrick AG, Gwynne H, Marie B, Jane Dixon MG. Focus on research methods the analysis and interpretation of cognitive interviews for instrument development. Res Nurs Health. 2007;30:224\u201334.","journal-title":"Res Nurs Health"},{"issue":"19","key":"1614_CR20","doi-asserted-by":"publisher","first-page":"44","DOI":"10.7748\/ns.24.19.44.s51","volume":"24","author":"JA Walker","year":"2013","unstructured":"Walker JA. Management of patients with carpal tunnel syndrome. Nurs Stand. 2013;24(19):44\u20138.","journal-title":"Nurs Stand"},{"key":"1614_CR21","unstructured":"Terwee CB, Prinsen CA, Chiarotto A, Cw De Vet H, Bouter LM, Marjan JA, et al. COSMIN methodology for assessing the content validity of PROMs User: manual version 1.0, 70; 2018. Available from: www.cosmin.nl."},{"issue":"4","key":"1614_CR22","doi-asserted-by":"publisher","first-page":"397","DOI":"10.3109\/17453678909149305","volume":"60","author":"R Luchetti","year":"1989","unstructured":"Luchetti R, Schoenhuber R, De CG, Alfarano M, Deluca S, Landi A. Carpal-tunnel pressure. Acta Orthop. 1989;60(4):397\u20139.","journal-title":"Acta Orthop"},{"issue":"2","key":"1614_CR23","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1016\/0363-5023(90)90124-A","volume":"15","author":"JN Katz","year":"1990","unstructured":"Katz JN, Stirrat CRJNK, Stirrat CR. A self-administered hand diagram for the diagnosis of carpal tunnel syndrome. J Hand Surg Am (Internet). 1990;15(2):360\u20133.","journal-title":"J Hand Surg Am (Internet)"},{"issue":"3","key":"1614_CR24","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s11552-007-9035-5","volume":"2","author":"SJ McCabe","year":"2007","unstructured":"McCabe SJ, Uebele AL, Pihur V, Rosales RS, Atroshi I. Epidemiologic associations of carpal tunnel syndrome and sleep position: Is there a case for causation? Hand. 2007;2(3):127\u201334.","journal-title":"Hand"},{"key":"1614_CR25","unstructured":"Edwards C. Are nerve conduction studies necessary? The development and evaluation of a patient-completed screening version of the Carpal Tunnel Questionnaire for use in primary care Submitted by Carl Edwards to the University of. 2015."},{"issue":"1","key":"1614_CR26","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1518\/001872007779598127","volume":"49","author":"PJ Keir","year":"2007","unstructured":"Keir PJ, Bach JM, Hudes M, Rempel DM. Guidelines for wrist posture based on carpal tunnel pressure thresholds. Hum Factors J Hum Factors Ergon Soc. 2007;49(1):88\u201399.","journal-title":"Hum Factors J Hum Factors Ergon Soc"},{"issue":"8","key":"1614_CR27","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1111\/1471-0528.13360","volume":"122","author":"M Meems","year":"2015","unstructured":"Meems M, Truijens SEM, Spek V, Visser LH, Pop VJM. Prevalence, course and determinants of carpal tunnel syndrome symptoms during pregnancy: a prospective study. BJOG An Int J Obstet Gynaecol. 2015;122(8):1112\u20138.","journal-title":"BJOG An Int J Obstet Gynaecol"},{"key":"1614_CR28","first-page":"7","volume":"11","author":"M Page","year":"2012","unstructured":"Page M, Massy-Westropp N, O\u2019Connor D, Pitt V. Splinting for carpal tunnel syndrome (review) summary of findings for the main comparison. Cochrane Database Syst Rev. 2012;11:7.","journal-title":"Cochrane Database Syst Rev"},{"issue":"10","key":"1614_CR29","doi-asserted-by":"publisher","first-page":"2067","DOI":"10.1016\/j.clinph.2011.02.030","volume":"122","author":"F Ortiz-Corredor","year":"2011","unstructured":"Ortiz-Corredor F, Calambas N, Mendoza-Pulido C, Galeano J, D\u00edaz-Ru\u00edz J, Delgado O. Factor analysis of carpal tunnel syndrome questionnaire in relation to nerve conduction studies. Clin Neurophysiol (Internet). 2011;122(10):2067\u201370. https:\/\/doi.org\/10.1016\/j.clinph.2011.02.030.","journal-title":"Clin Neurophysiol (Internet)"},{"issue":"4","key":"1614_CR30","first-page":"375","volume":"49","author":"AAA Zaher","year":"2012","unstructured":"Zaher AAA, Mattar MAB, Gomaa M, Zaher AAA. Value of contemporary investigation tools in management of carpal tunnel syndrome. Egypt J Neurol Psychiatry Neurosurg. 2012;49(4):375\u201380.","journal-title":"Egypt J Neurol Psychiatry Neurosurg"}],"container-title":["Health and Quality of Life Outcomes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12955-020-01614-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12955-020-01614-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12955-020-01614-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T17:10:56Z","timestamp":1605028256000},"score":1,"resource":{"primary":{"URL":"https:\/\/hqlo.biomedcentral.com\/articles\/10.1186\/s12955-020-01614-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,7]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1614"],"URL":"https:\/\/doi.org\/10.1186\/s12955-020-01614-7","relation":{},"ISSN":["1477-7525"],"issn-type":[{"value":"1477-7525","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,7]]},"assertion":[{"value":"25 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 November 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Hamilton Integrated Research Ethics Board (HIREB) at Hamilton, ON, Canada (project #5543), and all participants provided informed consent before participation.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"359"}}