“Quality of Randomized Controlled Trials for Surgical Treatment of Carpal Tunnel Syndrome: A Systematic Review”

BACKGROUND: Randomized controlled trials (RCTs) are considered the gold standard in evidence-based medicine. We conducted a systematic review to evaluate the quantity, quality, and trends of RCTs that assess surgical treatment of carpal tunnel syndrome (CTS). METHODS: We identified RCTs comparing two or more surgical interventions for CTS in PubMed, Cochrane, Scopus, Google Scholar, and Clinicaltrials.gov. Two independent reviewers evaluated manuscripts for inclusion, extracted data, and assessed RCT quality using the Jadad score. RESULTS: Of 2,253 identified studies, 58 met full inclusion criteria. They were published between 1985–2015, with a significant increase over time (p=0.003). They were most frequently published in Journal of Hand Surgery (European Volume) (n=15, 25.9%). Most RCTs were single-center studies (n=54, 93.1%) conducted in the UK (n=13, 22.4%) or the US (n=10, 17.2%), with a mean study size of 80.1±55.5 patients. Funding source was unknown in 62.1% (n=36). Three-quarters (n=44, 75.9%) of RCTs did not define primary outcome measure(s).

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