Quality of Carpal Tunnel Syndrome Patient Education Handouts Available on the Internet: A Systematic Analysis of Content and Design

Arch Phys Med Rehabil. 2021 Sep 18:S0003-9993(21)01419-2. doi: 10.1016/j.apmr.2021.08.010. Online ahead of print.


OBJECTIVE: To evaluate the quality of carpal tunnel syndrome (CTS) patient education handouts and identify the best resources for patients and clinicians.

DESIGN: A document content analysis of handouts identified through a systematic internet search using 8 search terms on Google and Bing and a hand search of professional association websites.

SETTING: Not Applicable.

PARTICIPANTS: Documents were identified from the top 50 search results across 16 individual searches. Included documents provided general patient education for CTS; descriptive websites, videos, and research studies were excluded.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Content analysis was conducted using the Information Score (IS) tool to evaluate completeness of information [0%-100%], and misleading treatment recommendations were identified. Design analysis was conducted using the Patient Material Assessment Tool (PEMAT-P) [0-100%] and two widely-used readability formulas, Flesch Reading Ease (FRE) and Flesch Kincaid Grade Level (FKGL). Using these results, all handouts were rated with a summative 12-point scale.

RESULTS: Of 805 unique search results, we included 56 CTS handouts. The average IS was 74.6% ± 17.9%. 78.6% of the handouts mentioned non-evidence-based treatment recommendations. The average PEMAT-P score was 70.2% ± 10.9% and the average readability grade level was 7.7 ± 1.7. Only 3 handouts were identified as high quality based on the 12-point summative scores, while 22 handouts had mixed quality and 17 handouts had low quality on both content and design.

CONCLUSIONS: Findings of this study suggest a lack of high-quality and easily understandable CTS patient education handouts. Most handouts contained unreliable treatment information. Improvements are needed to ensure patients’ ability to understand and manage this condition.

PMID:34547274 | DOI:10.1016/j.apmr.2021.08.010

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