Purpose: Utility is a measure of the impact of health on quality of life. The closer a utility is to 1, the better the quality of life; the closer it is to 0, the worse the quality of life. The purpose of this study was to assess the health utilities in patients with carpal tunnel syndrome and to determine the relationship of various health indicators with these utilities.

Methods: Sixty four patients seeking treatment for carpal tunnel syndrome participated in this prospective study. Symptom severity and functional limitations associated with hand and wrist symptoms were measured. Utility for the patient’s current health status was measured with the standard gamble (SG) and visual analog scale (VAS). In this study, utility was scaled between 0 (severe median nerve dysfunction) and 1 (absence of symptoms). A psychological measure of affect and the Katz hand diagram was also administered.

Results: The average SG utility was .60 (std. dev. = .29, 95% C.I. = .53-.67) and the average VAS utility was .47 (std. dev. = .26, 95% C.I. = .41-.53). The difference between the two utilities was significant (t(63) = 3.941, p<.001). Both utility measures were negatively related to symptom severity and functional limitations. The correlations of the SG utility with the symptom severity score (r = -.37) and with the function limitation score (r = -.29) were significant (p’s < .05). Likewise, the correlations of the VAS utility with the symptom severity score (r = -.57) and functional limitation score (r = -.36) were also significant (p’s < .01). The patient’s affect was unrelated to the SG utility (r = .03, p = .83) or the VAS utility (r = .15, p=.23). The Katz hand diagram was unrelated to the two utility measures (with the SG utility, r = .07, p=.59, and with the VAS utility, r = .03, p=.82). Symptom severity, functional limitation, affect, and Katz hand diagram accounted for only 14 percent of the variability in the SG utility (R = .38, p = .053) and 34 percent of the variability in VAS utility (R = .58, p<.001).

Conclusion: We have shown that utility varies inversely with disease severity. However, quality of life associated with carpal tunnel syndrome is only partially explained by symptom severity and functional limitations. Utility measures such as the SG and VAS capture unique aspects of disease impact and are an alternative method of measuring quality of life.