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Injection versus Decompression for Carpal Tunnel Syndrome-Pilot trial (INDICATE-P)—protocol for a randomised feasibility study

BACKGROUND: Carpal tunnel syndrome (CTS) is the commonest peripheral nerve disorder in the UK, with over 52,996 carpal tunnel decompressions performed in 2011. By 2030, this figure is estimated to double. Whilst evidence supports conservative measures for mild symptoms, and early surgery for severe...

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Autores principales: Mason, Will, Ryan, Daniel, Khan, Asif, Kerr, Hui-Ling, Beard, David, Cook, Jonathan, Rombach, Ines, Cooper, Cushla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402050/
https://www.ncbi.nlm.nih.gov/pubmed/28451442
http://dx.doi.org/10.1186/s40814-017-0134-y
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author Mason, Will
Ryan, Daniel
Khan, Asif
Kerr, Hui-Ling
Beard, David
Cook, Jonathan
Rombach, Ines
Cooper, Cushla
author_facet Mason, Will
Ryan, Daniel
Khan, Asif
Kerr, Hui-Ling
Beard, David
Cook, Jonathan
Rombach, Ines
Cooper, Cushla
author_sort Mason, Will
collection PubMed
description BACKGROUND: Carpal tunnel syndrome (CTS) is the commonest peripheral nerve disorder in the UK, with over 52,996 carpal tunnel decompressions performed in 2011. By 2030, this figure is estimated to double. Whilst evidence supports conservative measures for mild symptoms, and early surgery for severe symptoms, controversy remains over the most appropriate management for patients that present with moderate disease, with regard to early surgery or late surgery following steroid injection. Injection versus Decompression for Carpal Tunnel Syndrome-Pilot trial (INDICATE-P) is a feasibility study for a multicentre, randomised controlled trial (INDICATE) to determine whether patients over the age of 18 with moderate CTS should undergo early surgical decompression of the median nerve or a single steroid injection (followed by later surgery if required). METHODS/DESIGN: INDICATE-P is a feasibility study for an open (non-blinded) randomised controlled pilot trial. Eligible participants will be adults with a clinical diagnosis of moderate CTS. This is defined as symptoms disturbing sleep or restricting activities of daily living or work, despite a 2-week trial of night splints. Participants will be randomised to one of two possible interventions: surgical decompression or a single steroid injection (followed by surgery later if required). Clinical outcome measures will be captured by postal questionnaire at 1, 3, 6 and 12 months post-randomisation. In order to improve the study design for the main INDICATE trial, feasibility data will also be collected to identify difficulties in recruitment and retention, to gain patient feedback on questionnaires and to confirm the suitability of the proposed outcome measures. DISCUSSION: The INDICATE-P feasibility study will contribute to the design and execution of the INDICATE trial, which will seek to assess the safety and effectiveness of two approaches to treatment for patients over 18 years of age with moderate CTS: early carpal tunnel decompression or a single steroid injection (followed by later surgery).
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spelling pubmed-54020502017-04-27 Injection versus Decompression for Carpal Tunnel Syndrome-Pilot trial (INDICATE-P)—protocol for a randomised feasibility study Mason, Will Ryan, Daniel Khan, Asif Kerr, Hui-Ling Beard, David Cook, Jonathan Rombach, Ines Cooper, Cushla Pilot Feasibility Stud Study Protocol BACKGROUND: Carpal tunnel syndrome (CTS) is the commonest peripheral nerve disorder in the UK, with over 52,996 carpal tunnel decompressions performed in 2011. By 2030, this figure is estimated to double. Whilst evidence supports conservative measures for mild symptoms, and early surgery for severe symptoms, controversy remains over the most appropriate management for patients that present with moderate disease, with regard to early surgery or late surgery following steroid injection. Injection versus Decompression for Carpal Tunnel Syndrome-Pilot trial (INDICATE-P) is a feasibility study for a multicentre, randomised controlled trial (INDICATE) to determine whether patients over the age of 18 with moderate CTS should undergo early surgical decompression of the median nerve or a single steroid injection (followed by later surgery if required). METHODS/DESIGN: INDICATE-P is a feasibility study for an open (non-blinded) randomised controlled pilot trial. Eligible participants will be adults with a clinical diagnosis of moderate CTS. This is defined as symptoms disturbing sleep or restricting activities of daily living or work, despite a 2-week trial of night splints. Participants will be randomised to one of two possible interventions: surgical decompression or a single steroid injection (followed by surgery later if required). Clinical outcome measures will be captured by postal questionnaire at 1, 3, 6 and 12 months post-randomisation. In order to improve the study design for the main INDICATE trial, feasibility data will also be collected to identify difficulties in recruitment and retention, to gain patient feedback on questionnaires and to confirm the suitability of the proposed outcome measures. DISCUSSION: The INDICATE-P feasibility study will contribute to the design and execution of the INDICATE trial, which will seek to assess the safety and effectiveness of two approaches to treatment for patients over 18 years of age with moderate CTS: early carpal tunnel decompression or a single steroid injection (followed by later surgery). BioMed Central 2017-04-24 /pmc/articles/PMC5402050/ /pubmed/28451442 http://dx.doi.org/10.1186/s40814-017-0134-y Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Mason, Will
Ryan, Daniel
Khan, Asif
Kerr, Hui-Ling
Beard, David
Cook, Jonathan
Rombach, Ines
Cooper, Cushla
Injection versus Decompression for Carpal Tunnel Syndrome-Pilot trial (INDICATE-P)—protocol for a randomised feasibility study
title Injection versus Decompression for Carpal Tunnel Syndrome-Pilot trial (INDICATE-P)—protocol for a randomised feasibility study
title_full Injection versus Decompression for Carpal Tunnel Syndrome-Pilot trial (INDICATE-P)—protocol for a randomised feasibility study
title_fullStr Injection versus Decompression for Carpal Tunnel Syndrome-Pilot trial (INDICATE-P)—protocol for a randomised feasibility study
title_full_unstemmed Injection versus Decompression for Carpal Tunnel Syndrome-Pilot trial (INDICATE-P)—protocol for a randomised feasibility study
title_short Injection versus Decompression for Carpal Tunnel Syndrome-Pilot trial (INDICATE-P)—protocol for a randomised feasibility study
title_sort injection versus decompression for carpal tunnel syndrome-pilot trial (indicate-p)—protocol for a randomised feasibility study
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402050/
https://www.ncbi.nlm.nih.gov/pubmed/28451442
http://dx.doi.org/10.1186/s40814-017-0134-y
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