possible modernisation of questionnaire

Deborah.seabrook@ntlworld.com
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Thank you for such an informative and comprehensive website.

I have taken the survey and had a 27% chance of CTS but a low severity score. However, I was a little frustrated that the questionnaire did not ask some questions which would be relevant to me and to others I think. It occurred to me that the questionnaire is about 20 years old and so does not reflect changing lifestyles e.g......

1. I consider myself a fit 60 year old and regularly ride my bicycle. However, the extension of my wrists as I hold the handlebars quickly triggers tingling and numbness. I also get it sometimes when griping the car steering wheel.
2. I don't have trouble holding a book as I rarely do so. However, using my smart phone or typing on my iPad (as now) does trigger tingling and numbness.

Also, you mention 'Twanging' sensations but do not include that in the questionnaire. I do get twanging, especially when stirring a saucepan.

I realise the construction of the questionnaire is complex but just wonder whether modern lifestyle changes should be reflected in it.

Regards

jeremydpbland
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I'm always on the lookout for new questions that might improve the diagnostic accuracy and which could be added. However the amount of data required to incorporate a new question is rather mind-boggling. The existing questionnaire is derived from study of over 5000 patients, for whom I need not only the full set of answers but also their final diagnoses derived from nerve conduction tests, treatment outcomes etc. Adding a new question for actual use requires the collection of a few thousand more before we can score it and incorporate it into the calculation. If everyone who took the questionnaire on the website provided their follow-up diagnosis in due course then we could collect such data fairly quickly but of course few people do that so I am mostly limited by the number of people who I can see personally. The other things to consider is whether any proposed question is applicable to a large proportion of the potential patents (relatively few people who have CTS for example ride a bike, at least in the UK, so although symptoms precipitated by riding are fairly typical of CTS you only get this history from <1% of individuals overall) and whether the answer is sufficiently useful to justify making the questionnaire even longer - it's already a bit of a job of work to complete. 

I can't remove old questions either because the mathematics behind the site uses all of them.

Thankyou for the suggestions however - I have quite a long list of possible items for exploration. JB

Deborah.seabrook@ntlworld.com
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Thank you for taking the trouble to give such a long and thorough reply, which was most interesting.

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