Cultural adaptation, translation and validation of Cochin Hand Function Scale and evaluation of hand dysfunction in systemic sclerosis

Bairwa, Devender; Kavadichanda, Chengappa; Adarsh, M B; Gopal, Aishwarya; Negi, Vir Singh

doi:10.1007/s10067-020-05434-4

Cited by 4 publications

(4 citation statements)

References 33 publications

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“…We have previously demonstrated that traditional outcome measures tend to underperform in our population, 14 necessitating a population-specific evaluation. The Indian subcontinent has marked diversity in terms of ethnicity, genetic makeup, 15 and physical characteristics including skin color.…”

Section: Introductionmentioning

confidence: 96%

Effect of skin phototype on quantitative nailfold capillaroscopy

Bairwa

Kavadichanda

Dunga

et al. 2022

Journal of Scleroderma and Related Disorders

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Objectives: To determine the impact of Fitzpatrick scale-based skin phototype on visualization of capillary density using nailfold capillaroscopy in healthy Indian adults. Methods: In this cross-sectional study, healthy adults were examined for nailfold capillaroscopy findings utilizing a portable capillary microscope at 800× magnification. Photographs of two contiguous areas measuring 1 mm2 each of the distal row of capillaries were captured. Images were captured from the central area of all fingers except thumb in both hands. Capillary density and morphology of nailfold capillaroscopies were assessed by two blinded assessors. The nailfold capillaroscopy parameters were compared between the Standard Fitzpatrick scale-based skin phototypes. Results: A total of 118 healthy adults were enrolled in the study. Type III, IV, V, and VI skin phototypes were seen in 27 (22.90%), 32 (27.19%), 29 (24.58%), and 30 (25.42%) participants, respectively. All participants (100%) had normal nailfold capillaroscopy morphology and architecture. Zero capillaries were visible in 11 fingers among 5 patients (4.24%) and all of them had Type VI phototype. The median capillary density per mm was 5.19 (interquartile range = 4.37–6.75) with 90 (76.27%) participants having less than seven capillaries. The median average capillary density was significantly different ( p-value < 0.0001) across Type III (8.13, interquartile range = 6.44–8.88), Type IV (5.67, interquartile range = 4.41–6.98), Type V (4.94, interquartile range = 4.19–5.38), and Type VI (4.53, interquartile range = 3.72–4.91) phototypes ( p < 0.05). Conclusion: The number of capillaries visualized during nailfold capillaroscopy decreases as the skin pigmentation increases. There is a need to redefine the nailfold capillaroscopy density and avascularity by taking skin phototype as one of the determinants before labeling a nailfold capillaroscopy finding with less visualized capillaries as abnormal.

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Section: Introductionmentioning

confidence: 96%

Effect of skin phototype on quantitative nailfold capillaroscopy

Bairwa

Kavadichanda

Dunga

et al. 2022

Journal of Scleroderma and Related Disorders

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Section: Introductionmentioning

confidence: 99%

“…Functional hand impairment is a primary determinant of disability in systemic sclerosis (SSc) patients 1 2 relevant to both limited and diffuse cutaneous clinical subsets of the disease. Reduced hand function starts very early as the consequence of Raynaud's phenomenon (RP) and later in the natural history due to severe inflammation or fibrosis of skin, 3 digital ulcers, 4 calcinosis, 5 6 and inflammation or fibrosis of joints and periarticular tissues. 7 8 Despite this profound impact on the disease and the reported clinical association in crosssectional populations, the prevalence and rate of deterioration in hand function over time in SSc patients is largely unknown, as well as the clinical and demographic factors…”

Section: Introductionmentioning

confidence: 99%

Clinical trajectories of hand function impairment in systemic sclerosis: an unmet clinical need across disease subsets

De Lorenzis,

Kakkar,

Di Donato

et al. 2024

RMD Open

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BackgroundHand involvement is an early manifestation of systemic sclerosis (SSc), culprit of diagnosis and classification, and recognised major driver of disability. Impairment of hand function burdens both limited and diffuse cutaneous subsets and therefore could be targeted as ‘basket’ endpoint in SSc. Nevertheless, its natural history in current standard of care is not well characterised, limiting the design of targeted trials. The aim of this study is to describe prevalence, natural history and clinical factors associated with hand function deterioration in a longitudinal, multicentre, observational SSc cohort.MethodsHand function was captured through the validated Cochin Hand Function Scale in patients consecutively enrolled in a multicentre observational study and observed over 24 months. Minimal clinically important differences and patient acceptable symptom state were analysed as previously described.ResultsThree hundred and ninety-six consecutive patients were enrolled from 10 centres; 201 with complete follow-up data were included in the analysis. Median (IQR) disease duration was 5 (2–11) years. One hundred and five (52.2%) patients reported clinically significant worsening. Accordingly, the proportion of patients reporting unacceptable hand function increased over 2 years from 27.8% to 35.8% (p<0.001). Least absolute shrinkage and selection operator analysis identified male gender, disease subset, Raynaud’s Condition Score, tenosynovitis and pain, as some of the key factors associated with worsening hand involvement.ConclusionsHand function deteriorates over time in more than 50% of SSc patients despite available therapies. The analysis of factors associated with hand function worsening supports the involvement of both inflammation, vascular and fibrotic processes in hand involvement, making it a hallmark clinical manifestation of SSc. Our data are poised to inform the design of intervention studies to target this major driver of disability in SSc.

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“…2,[6][7][8][9] The self-report CHFS consists of 18 items used to assess a person's ability to perform daily handrelated activities. 4 The cross-language validity of the CHFS is important in SSc because SSc is a rare disease, 10 and people who complete a scale in different languages are commonly included in the same study, 11 especially when the study is carried out in countries or regions with more than one commonly spoken language, such as Canada (eg, French and English). Additionally, for rare diseases such as SSc, international collaboration and recruitment of participants from different countries who use different languages is often necessary to include sufficient numbers of participants in a given study.…”

Section: Introductionmentioning

confidence: 99%

Differential Item Functioning on the Cochin Hand Function Scale Among People With Systemic Sclerosis by Language, Sex, and Disease Subtype: A Scleroderma Patient‐Centered Intervention Network (SPIN) Cohort Study

Xu,

Harel,

Carrier

et al. 2023

Arthritis Care & Research

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ObjectiveThe Cochin Hand Function Scale (CHFS) is commonly used among people with systemic sclerosis (SSc), including study participants who speak different languages, are of different sexes, or have different disease subtypes. It is not known, however, whether CHFS displays differential item functioning (DIF) and if scores from participants in different groups can be treated equivalently. We evaluated the degree that the CHFS generates scores that are comparable across language, sex, and disease subtype.MethodsWe included participants enrolled in the Scleroderma Patient‐centered Intervention Network (SPIN) Cohort who completed the CHFS at their baseline assessment between April 2014 and September 2020. Confirmatory factor analysis (CFA) was used to test unidimensionality, and Multiple Indicator Multiple Cause (MIMIC) models were used for DIF analysis based on language, sex, and disease subtype. Both intraclass correlation coefficient (ICC) and Pearson's correlation were calculated using factor scores obtained from unadjusted and DIF‐adjusted MIMIC models to evaluate agreement and correlation between scores.Results2155 participants were included. CFA with covarying error terms supported a good fit of the model (χ2[127] =1754.671, P < 0.001, TLI = 0.985, CFI = 0.987, RMSEA = 0.077). Nine items displayed statistically significant DIF for language of administration, 10 items for sex, and 10 items for disease subtype. However, the overall impact of DIF was negligible when comparing factor scores that did and did not account for DIF (ICC= 0.999, r = 0.999).ConclusionThe CHFS has score comparability in SSc regardless of participants’ language, sex, and disease subtype.This article is protected by copyright. All rights reserved.

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Cultural adaptation, translation and validation of Cochin Hand Function Scale and evaluation of hand dysfunction in systemic sclerosis

Cited by 4 publications

References 33 publications

Effect of skin phototype on quantitative nailfold capillaroscopy

Effect of skin phototype on quantitative nailfold capillaroscopy

Clinical trajectories of hand function impairment in systemic sclerosis: an unmet clinical need across disease subsets

Differential Item Functioning on the Cochin Hand Function Scale Among People With Systemic Sclerosis by Language, Sex, and Disease Subtype: A Scleroderma Patient‐Centered Intervention Network (SPIN) Cohort Study

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