{"id":"ac7252bd-3764-4f7e-92d1-60987c7c8905","slug":"randomized-clinical-trials-in-carpal-tunnel-release-a-double-edged-sword","title":"Randomized clinical trials in carpal tunnel release: A double-edged sword","authors":["Hussam Abou-Al-Shaar","Mark A. Mahan"],"abstract":"Background: Carpal tunnel syndrome (CTS) is the most prevalent compressive neuropathy, significantly impacting the workforce and resulting in a high socioeconomic burden. Surgical release is often necessary when conservative treatments fail, with a notable increase in minimally invasive procedures. The debate over the superiority of open versus endoscopic carpal tunnel release has persisted for two decades, necessitating randomized clinical trials (RCTs) to provide clarity. Summary: RCTs have produced contradictory results regarding the effectiveness of surgical techniques for CTS, leading to confusion among practitioners. Many trials have employed rigorous methodological criteria that inadvertently introduce biases, as they often exclude patients with common comorbidities. This letter highlights potential biases in CTS RCTs, including allocation concealment and reporting biases, which may skew outcomes and limit the applicability of trial results to real-world clinical scenarios. Conclusion: The findings from CTS RCTs reflect specific selection criteria and favored outcome assessments rather than real-world conditions. It is crucial to recognize these biases when interpreting trial results and to approach the application of such findings in clinical practice with caution. Keywords: carpal tunnel syndrome, RCTs, surgical techniques, bias, outcomes, methodology, comorbidities","thumbnailUrl":null,"publishDate":"2018-02-21T00:00:00.000Z","doi":"10.4103/sni.sni_355_17","categories":["Randomized Controlled Trials","Letter to the Editor"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2018/03/8781/SNI-9-42.pdf"}