Development of a patient-oriented outcome measure for patients with hand and elbow disorder: HandQ

Purpose: The Disabilities of the Arm, Shoulder, and Hand (DASH) is the most widely used patient-oriented outcome measure for the upper extremities in the world, and high reliability and validity of it has already been confirmed. However, there are several problems with using the DASH, some of which are culturally related. We aimed to (1) develop a patient-oriented disease-specific outcome measure for patients with disorders of the hand and elbow, which we call the HandQ and (2) examine the practical applicability, reliability, and validity of the HandQ for any patient with disorders of the hand and elbow. Methods: A total of 216 patients were surveyed with the HandQ, as well as the Hand20 and the DASH to assess psychometric characteristics. Results: There were no considerable floor and ceiling effects regarding the total HandQ score. Test–retest reliability and internal consistency determined using the intraclass correlation coefficient (0.942) and Cronbach’s α test (0.961) were excellent. The HandQ was well correlated with the Hand20 and the DASH scores. Scree plot showed unidimensionality of the HandQ, and the graphical model showed the questionnaire items of the HandQ had reasonable correlation among each item. Conclusions: The HandQ has a sufficient reliability and internal consistency, and an excellent validity, and was shown to be able to be practically applicable in all patients with hand and elbow disorders.

Development of a patient-oriented outcome measure for patients with hand and elbow disorder: HandQ

Background: We aimed to develop a patient-oriented disease-specific outcome measure for patients with disorders of the hand and elbow, which we call the HandQ, and examine the practical applicability, reliability and validity of the HandQ for any patient with disorders of the hand and elbow. Methods: A total of 216 patients were surveyed with the HandQ, as well as the Hand20 and the DASH to assess psychometric characteristics. Results: Test-retest reliability and internal consistency determined using the intraclass correlation coefficient (0.942) and Cronbach’s alpha test (0.961) were excellent. The HandQ was well correlated with the other questionnaires. Scree plot showed uni-dimensionality of the HandQ, and the graphical model showed the questionnaire items of the HandQ had reasonable correlation among each item. Conclusions: The HandQ has a sufficient reliability and internal consistency, and an excellent validity, and was shown to be able to be practically applicable in all patients with hand and elbow disorders.

What patients want from the treatment of Dupuytren’s disease — is the Unité Rhumatologique des Affections de la Main (URAM) scale relevant?

Patients awaiting surgery for Dupuytren’s contractures listed the problems from their Dupuytren’s disease that had led them to request surgery and their relative priorities of the results of surgery. The listed problems were compared with the nine items comprising the Unité Rhumatologique des Affections de la Main (URAM) Dupuytren’s disease-specific outcome measure. One hundred and ten patients reported 278 problems. Ninety-four different combinations of problems were provided by patients, and over half (55%) of the problems were not captured by items in the URAM scale. The long-term outcome from surgery was relatively more important to patients than speed of recovery. The URAM tool may not be relevant to patients in the UK, and further assessment of its face validity is required before it is used. Level of evidence: III