Which Outcome Measure is the Best? Evaluating Responsiveness of the Disabilities of the Arm, Shoulder, and Hand Questionnaire, the Michigan Hand Questionnaire and the Patient-Specific Functional Scale following Hand and Wrist Surgery

Abstract

The purpose of this study was to determine and compare the responsiveness of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Michigan Hand Questionnaire (MHQ), and the Patient-Specific Functional Scale (PSFS) in patients with carpal tunnel syndrome, wrist pain, finger contracture, or tumor. Eighty-one subjects prospectively completed each questionnaire shortly before and 3 and 6 months after surgery. Data were analyzed using one-way analysis of variance and Newman-Keuls multiple comparison tests. Responsiveness to clinical change was calculated using standardized response means. The DASH was responsive for those with carpal tunnel syndrome (0.77), wrist pain (0.61), and tumor (0.55); the MHQ was responsive for those with carpal tunnel syndrome (1.04), wrist pain (0.87), and finger contracture (0.62); and the PSFS was responsive for those with carpal tunnel syndrome (0.65) and finger contracture (0.64). The interval during which the highest responsiveness occurred for the carpal tunnel, wrist pain, and finger contracture groups was the preoperative to 6-month period. The tumor group experienced the highest responsiveness during the preoperative to 3-month period. Our results indicate that one or more of the instruments evaluated are suitable for outcomes research related to surgery to treat carpal tunnel syndrome, wrist pain, finger contracture, and tumor.

Validity of the Patient Specific Functional Scale in Patients following Upper Extremity Nerve Injury

“…In our study, the mean DASH score was 44.1, which indicates a high level of upper extremity disability compared to the US normative value (10.1±14.9) previously reported [14]. Our study of patients with nerve injury supports previous studies which have provided evidence of validity of this measure in patients with upper extremity pathologies [12,17,28]. In patients with upper extremity nerve injury we found high levels of disability as measured by self-report particularly in patients with brachial plexus nerve injury.…”

Measurement properties of patient-specific instruments measuring physical function

“…None of these instruments has been tested on all psychometric quality criteria of the checklist. One instrument has been tested positively on four items [73], nine on two items [13,72,78e80,84,85,87,91,92], five on one item [74,77,81,82,88], and six instruments have not been evaluated positively on any of the items [12,75,76,86,89,90].…”

The Impact of Depression and Pain Catastrophization on Initial Presentation and Treatment Outcomes for Atraumatic Hand Conditions

“…Both of these scales were chosen because they have been previously validated and used in similar studies 5,25,28,[34][35][36][37][38][39] . To assess hand function, subjects completed the seventy-one-question MHQ (a scale of 0 to 100, with 100 indicating the best hand performance), which was chosen because it distinguishes the left and right hand and includes subscales [40][41][42][43][44][45][46][47][48][49][50] . Patient demographic information collected included date of birth, sex, ethnic and racial background, self-report of clinically diagnosed depression, whether the patient was currently receiving treatment for depression, and contact information.…”