Evidence map›Paper›PMID 35394019›Full record

Trial reportRheumatology (Oxford, England)2023

The effectiveness of corticosteroid injection versus night splints for carpal tunnel syndrome: 24-month follow-up of a randomized trial.

Claire Burton, Trishna Rathod-Mistry, Steven Blackburn, Milica Blagojevic-Bucknall, Linda Chesterton, Graham Davenport, Krysia Dziedzic, Adele Higginbottom, Sue Jowett, Helen Myers and 4 more

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Rheumatology (Oxford, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

Claire BurtonSchool of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.ORCID 0000-0003-4688-3075
Trishna Rathod-MistrySchool of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.
Steven BlackburnSchool of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.
Milica Blagojevic-BucknallSchool of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.
Linda ChestertonSchool of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.
Graham DavenportSchool of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.
Krysia DziedzicSchool of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.
Adele HigginbottomSchool of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.
Sue JowettInstitute of Applied Health Research, University of Birmingham, Birmingham.
Helen MyersSchool of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.
Raymond OppongInstitute of Applied Health Research, University of Birmingham, Birmingham.ORCID 0000-0002-0815-4616
Danielle van der WindtSchool of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.
Elaine HaySchool of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.
Edward RoddySchool of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.
Arthritis UK · GBUniversity of Birmingham · GBMidlands Partnership NHS Foundation Trust · GB

Funding

Department of Health KNRF-2012–03-002Versus Arthritis 20105Versus Arthritis 21019
6 · The paper itself

Abstract

objectivesThis follow-up study of the INSTinCTS (INjection vs SplinTing in Carpal Tunnel Syndrome) trial compared the effects of corticosteroid injection (CSI) and night splinting (NS) for the initial management of mild-to-moderate CTS on symptoms, resource use and carpal tunnel surgery, over 24 months.

methodsAdults with mild-to-moderate CTS were randomized 1:1 to a local corticosteroid injection or a night splint worn for 6 weeks. Outcomes at 12 and 24 months included the Boston Carpal Tunnel Questionnaire (BCTQ), hand/wrist pain intensity numeric rating scale (NRS), the number of patients referred for and undergoing CTS surgery, and healthcare utilization. A cost-utility analysis was conducted.

resultsOne hundred and sixteen participants received a CSI and 118 a NS. The response rate at 24 months was 73% in the CSI arm and 71% in the NS arm. By 24 months, a greater proportion of the CSI group had been referred for (28% vs 20%) and undergone (22% vs 16%) CTS surgery compared with the NS group. There were no statistically significant between-group differences in BCTQ score or pain NRS at 12 or 24 months. CSI was more costly [mean difference £68.59 (95% CI: -120.84, 291.24)] with fewer quality-adjusted life-years than NS over 24 months [mean difference -0.022 (95% CI: -0.093, 0.045)].

conclusionOver 24 months, surgical intervention rates were low in both groups, but less frequent in the NS group. While there were no differences in the clinical effectiveness of CSI and NS, initial treatment with CSI may not be cost-effective in the long-term compared with NS.

Indexed as

Carpal Tunnel SyndromeAdrenal Cortex HormonesAdultFollow-Up StudiesHumansSplintsTreatment OutcomeAdrenal Cortex Hormonescarpal tunnel syndromeclinical trialprimary care

Identifiers

PMID35394019
PMCPMC9891401
OpenAlexW4226287976

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.