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Huddleston HP, Mehta N, Lavoie-Gagne OZ, Maheshwer B, Fu MC, Cole BJ, Verma NN, Forsythe B, Yanke AB. Patient-reported outcomes measurement information system depression psychometrically underperforms compared to legacy measures and is poorly associated with postoperative functional outcomes in shoulder arthroplasty patients. Shoulder Elbow 2023; 15:626-633. [PMID: 37981972 PMCID: PMC10656966 DOI: 10.1177/17585732221137555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/18/2022] [Indexed: 11/21/2023]
Abstract
Background The purpose of this study was to investigate the associations between each mental health patient-reported outcome measure with postoperative functional outcomes following shoulder arthroplasty, and to compare psychometric properties of patient-reported outcomes measurement information system depression to the legacy (VR-12 Mental) patient-reported outcome measure. Methods Patients who underwent primary shoulder arthroplasty from July 2018 to February 2019 were retrospectively reviewed. Patient-reported outcomes measurement information system depression and VR-12 Mental were administered preoperatively; American Shoulder and Elbow Surgeons and Single Assessment Numeric Evaluation were administered at 6-month and 1-year postoperatively. Rasch partial credit modeling analysis was used to compare psychometric properties of legacy versus patient-reported outcomes measurement information system instruments in assessing mental health. Results Ninety-three patients who underwent total shoulder arthroplasty (n = 52), reverse total shoulder arthroplasty (n = 39), or hemiarthroplasty (n = 2) were included. Preoperative VR-12 Mental scores were moderately associated with American Shoulder and Elbow Surgeons at 6-months (coefficient: 0.52, P = 0.026) and 1-year (coefficient: 0.65, P = 0.002), while preoperative patient-reported outcomes measurement information system depression scores were not. Patient-reported outcomes measurement information system depression demonstrated significant floor effects (16%); VR-12 Mental demonstrated minimal floor and ceiling effects (1.1% for both). VR-12 Mental demonstrated broader coverage of mental outlook on Rasch modeling than patient-reported outcomes measurement information system depression and had adequate model fit after one round of reiterative item elimination. Discussion Patient-reported outcomes measurement information system depression was poorly associated with postoperative American Shoulder and Elbow Surgeons scores, demonstrated significant floor effects, and had limited coverage of mental health on Rasch modeling with reiterative elimination. Level of Evidence IV.
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Affiliation(s)
| | - Nabil Mehta
- Department of Orthopedics, Rush University Medical Center, Chicago, IL, USA
| | | | - Bhargavi Maheshwer
- Department of Orthopedic Surgery, Case Western Reserve University, Cleveland, OH, USA
| | | | - Brian J Cole
- Department of Orthopedics, Rush University Medical Center, Chicago, IL, USA
| | - Nikhil N Verma
- Department of Orthopedics, Rush University Medical Center, Chicago, IL, USA
| | - Brian Forsythe
- Department of Orthopedics, Rush University Medical Center, Chicago, IL, USA
| | - Adam B Yanke
- Department of Orthopedics, Rush University Medical Center, Chicago, IL, USA
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Huddleston HP, Lavoie-Gagne O, Mehta N, Walsh JM, Fu MC, Forsythe B, Verma NN, Cole BJ, Yanke AB. PROMIS physical function and pain perform poorly psychometrically in patients undergoing medial patellofemoral ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2023; 31:5067-5076. [PMID: 37823904 DOI: 10.1007/s00167-023-07535-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 07/28/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE The purpose of this study was to assess the validity, floor and ceiling effects, and dimensionality of PROMIS Physical Function (PF) and Pain compared to legacy patient reported outcome (PRO) measures in patients undergoing medial patellofemoral ligament (MPFL) reconstruction. METHODS Patients who underwent MPFL reconstruction between 2018 to 2020 were retrospectively reviewed. Preoperatively, patients completed the IKDC, VR-12, Kujala, SF-12, KOOS JR, PROMIS PF and Pain surveys. Inter-survey convergence was assessed with Spearman correlations. Psychometric analysis included investigations of inter-survey convergent validity, intra-survey floor and ceiling effects, and Rasch analyses with person-item fit and iterative question elimination model fit testing. RESULTS A total of 76 patients (mean age: 22.6 ± 8.4 years) who completed preoperative surveys were included (compliance: 91.7-96.2%). Preoperatively, age was significantly associated with both PROMIS PF (coefficient: - 0.291, P = 0.005) and Pain scores (coefficient: 0.294, P = 0.002). PROMIS PF had a Very Good correlation with IKDC and PROMIS Pain had a Very Good correlation with KOOS JR. Other correlations ranged from Poor to Good. No significant floor or ceiling effects were observed for any PRO. On iterative question elimination Rasch modelling, only two questions from PROMIS PF remained after 6 rounds of elimination while PROMIS Pain had no questions remaining after 3 rounds of elimination. CONCLUSION Preoperative PROMIS PF and Pain provided only Fair to Good correlations with most legacy PROs. Although no significant floor and ceiling effects were observed, PROMIS PF and Pain did not perform well psychometrically in this population of patients undergoing MPFL reconstruction. These results suggest PROMIS questionnaires should be used with caution in this population, especially if used in isolation, when discussing clinical expectations with patients. The authors recommend continued use of legacy PROs specific to assessment of patellar instability and function that have established validity in patellar instability populations. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Hailey P Huddleston
- Rush University Medical Center, 1611 W. Harrison Street, Chicago, IL, 60612, USA
- Hospital for special surgery, New York, NY, USA
| | - Ophelie Lavoie-Gagne
- Rush University Medical Center, 1611 W. Harrison Street, Chicago, IL, 60612, USA
- Harvard, Cambridge, MA, USA
| | - Nabil Mehta
- Rush University Medical Center, 1611 W. Harrison Street, Chicago, IL, 60612, USA
| | - Justin M Walsh
- Rush University Medical Center, 1611 W. Harrison Street, Chicago, IL, 60612, USA
- Houston Methodist, Houston, TX, USA
| | - Michael C Fu
- Rush University Medical Center, 1611 W. Harrison Street, Chicago, IL, 60612, USA
| | - Brian Forsythe
- Rush University Medical Center, 1611 W. Harrison Street, Chicago, IL, 60612, USA
| | - Nikhil N Verma
- Rush University Medical Center, 1611 W. Harrison Street, Chicago, IL, 60612, USA
| | - Brian J Cole
- Rush University Medical Center, 1611 W. Harrison Street, Chicago, IL, 60612, USA
| | - Adam B Yanke
- Rush University Medical Center, 1611 W. Harrison Street, Chicago, IL, 60612, USA.
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Kwan SA, Tulipan JE, Hameed D, Matzon JL. Effect of Perioperative Corticosteroid Administration on Early Postoperative Range of Motion and Functional Outcomes Following Dupuytren's Fasciectomy. Hand (N Y) 2023; 18:925-930. [PMID: 35321575 PMCID: PMC10470228 DOI: 10.1177/15589447221084013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The purpose of the study was to evaluate whether perioperative corticosteroid (CS) administration improves early postoperative range of motion (ROM) and function in patients undergoing Dupuytren's fasciectomy. METHODS We retrospectively identified 58 patients who underwent Dupuytren's fasciectomy by a single fellowship-trained orthopedic hand surgeon from 2016 to 2020. During this time period, 51 digits in 34 patients received a single intraoperative dose of 10 mg of intravenous dexamethasone followed by a 6-day oral methylprednisolone taper course (CS group), and 37 digits in 24 patients did not (control group). Postoperatively, all patients started hand therapy within 1 week of surgery. At 2 and 6 weeks, patients had ROM data and Disabilities of the Arm, Shoulder, and Hand (DASH) scores collected by a blinded hand therapist. Paired t tests were used to compare the change in ROM and DASH scores at weeks 2 and 6. RESULTS The 2 cohorts had similar preoperative ROM. At 2 weeks postoperatively, the CS group had greater metacarpophalangeal (MP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) flexion. There was no difference in MP, PIP, or DIP extension. At 6 weeks postoperatively, the CS group had greater PIP flexion. There was no difference between the groups in MP extension, MP flexion, PIP extension, DIP extension, or DIP flexion. Mean DASH scores were significantly lower in the CS group at weeks 2 and 6. There were no postoperative deep infections or complications requiring surgery in either group. CONCLUSION Perioperative CS administration appears to be safe and to improve early ROM and DASH scores following Dupuytren's fasciectomy.
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Affiliation(s)
| | - Jacob E. Tulipan
- Thomas Jefferson University and Rothman Orthopaedic Institute, Philadelphia, PA, USA
| | - Daniel Hameed
- Thomas Jefferson University and Rothman Orthopaedic Institute, Philadelphia, PA, USA
| | - Jonas L. Matzon
- Thomas Jefferson University and Rothman Orthopaedic Institute, Philadelphia, PA, USA
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Ajiki T, Murayama A, Hayashi Y, Takeshita K. Validation of a Handprint for Clinical Evaluation of Dupuytren's Contracture. J Hand Microsurg 2023; 15:181-187. [PMID: 37388561 PMCID: PMC10306974 DOI: 10.1055/s-0041-1735347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Objective We have developed a handprint-based method for visualizing and quantifying the palmar contact of patients with Dupuytren's contracture. The purpose of this study was to examine whether the generated handprint was useful for assessing the severity of flexion contracture of the fingers and for evaluating the therapeutic effects of collagenase clostridium histolyticum (CCH) injection for Dupuytren's contracture. Methods The handprint was created by applying medical-grade ethanol-containing hand sanitizer over the entire palmar surface of the affected hand and then pressing it on thermal paper for word processors. The reliability of the handprint was evaluated through test-retest of 10 healthy volunteers at an interval of 10 days, and the validity of the handprint was assessed using a flexion contracture model in which the little finger was fixed in an Alfence splint. In addition, we obtained handprints of the affected hand in 33 patients with unilateral Dupuytren's contracture both before CCH injection and at the final observation after injection to investigate the contact area of the hand (CAH) and the length of the hand (LH). The relationships between CAH, LH, total extension deficit angle (TEDA), and patient-reported outcome measures (Japanese Society for Surgery of the Hand Version of the Quick Disability of Arm, Shoulder, and Hand Questionnaire [Quick DASH-JSSH] and Hand20) were examined. Results The test-retest correlation coefficient was 0.9187 ( p < 0.001) for CAH and 0.9052 ( p < 0.001) for LH, indicating high reliability of the handprint. The ratios of CAH and LH decreased gradually as the contracture angle of the splinted finger increased. The handprint revealed a marked improvement of palmar contact after CCH injection for Dupuytren's contracture. Furthermore, the ratios of CAH and LH were strongly correlated with TEDA, Quick DASH-JSSH, and Hand20 before treatment. Conclusion Our handprint-based assessment method was extremely useful for clinical evaluation of CCH treatment for Dupuytren's contracture. Type of Study/Level of Evidence Therapeutic.
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Affiliation(s)
- Takashi Ajiki
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
- Department of Orthopedic Surgery, Ishibashi General Hospital, Tochigi, Japan
| | - Akira Murayama
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
| | - Yukinori Hayashi
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
| | - Katsushi Takeshita
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
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de Klerk S. Assessment of structural and cross-cultural validity of the Disabilities of the Arm, Shoulder and Hand questionnaire: a scoping review. HAND THERAPY 2023; 28:3-15. [PMID: 37904812 PMCID: PMC10584070 DOI: 10.1177/17589983221140433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 11/03/2022] [Indexed: 11/01/2023]
Abstract
Introduction The Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire is a patient-reported outcome measure (PROM) that has been translated and cross-culturally adapted to at least 50 languages. Since the measure was developed in 1996, many researchers have reported on the construct validity (including structural and cross-cultural validity) of this instrument following translation and cross-cultural adaptation. The aim of this scoping review was to identify the methods used for the psychometric evaluation of structural and cross-cultural validity of the DASH questionnaire. Methods The updated methodological guidance for the conduct of scoping reviews and the PRISMA Extension for scoping reviews checklist was utilised. EBSCOHost (Academic Search Premier, Africa Wide, CINAHL, E-Journals and Medline), PubMed and Google Scholar were searched for articles (published between 1996-2022) and considered against the eligibility criteria. Results The scoping review collated evidence across 50 articles (37 language versions) of the evaluation of structural and cross-cultural validity of the DASH questionnaire. Three articles conducted confirmatory factor analysis (CFA) to assess structural validity, and none performed Multiple Group Confirmatory Factor Analysis (MGCFA) to assess cross-cultural validity. Conclusion The COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) taxonomy propose that structural validity is best evaluated through CFA, with prior evidence of dimensionality. Additionally, cross-cultural validity (measurement invariance) is to be evaluated through MGCFA. This review identified that CFA is utilised infrequently and that to date cross-cultural validity has not been appropriately assessed for translations of the DASH questionnaire.
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Affiliation(s)
- Susan de Klerk
- Division of Occupational Therapy, Department of Health and Rehabilitation Science, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
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de Klerk S, Jerosch-Herold C, Buchanan H, van Niekerk L. Structural and cross-cultural validity of the Afrikaans for the Western Cape Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. J Patient Rep Outcomes 2023; 7:1. [PMID: 36629952 PMCID: PMC9834491 DOI: 10.1186/s41687-022-00536-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 12/18/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire has been translated and cross-culturally adapted to Afrikaans for the Western Cape, within the public health service context of South Africa. The aim of this study was to evaluate structural validity, internal consistency, and cross-cultural validity/measurement invariance of this new translation to increase applicability and clinical utility in a public health service context. METHODS During this cross-sectional study, exploratory factor analysis (EFA) was conducted with parallel analysis and oblimin rotation. Confirmatory factor analysis (CFA) and multiple group confirmatory factor analysis (MGCFA) to assess cross-cultural validity/measurement invariance, was employed to test model fit with X2 goodness-of-fit statistic, root mean square error of approximation (RMSEA), standardized root mean square residual (SRMR) and comparative fit index (CFI). Internal consistency was calculated using Cronbach's alpha. RESULTS 109 women and 110 men (n = 219) completed the Afrikaans for the Western Cape and the South African English DASH questionnaire, used during the analysis. Unidimensionality of the Afrikaans for the Western Cape DASH questionnaire was not supported in the 218 questionnaires eligible for inclusion in the analysis [X2 (df) = 1799.10 (405); p value = < 0.01; RMSEA (90% CI) = 0.126 (0.120-0.132); SRMR = 0.09 and CFI = 0.984]. EFA revealed a two-factor structure with Eigenvalues exceeding one explaining 55% and 7% of the variance. The two-factor structure of the Afrikaans for the Western Cape DASH questionnaire was supported during CFA. Cronbach's alpha revealed good internal consistency of both factors [factor 1 = 0.97 (0.96, 0.97) and factor 2 = 0.92 (0.90, 0.94)]. MGCFA conducted between 218 Afrikaans for the Western Cape DASH and 219 South African English DASH questionnaires (N = 437) revealed that the data supports configural, metric and scalar invariance models during initial model fit assessment. Subsequent hypotheses testing comparing the nested models revealed that scalar invariance holds. CONCLUSION The Afrikaans for the Western Cape DASH questionnaire revealed a two-factor structure with good internal consistency across the two factors and demonstrated measurement invariance with the South African English DASH questionnaire.
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Affiliation(s)
- Susan de Klerk
- grid.11956.3a0000 0001 2214 904XDivision of Occupational Therapy, Department of Health and Rehabilitation Science, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | | | - Helen Buchanan
- grid.7836.a0000 0004 1937 1151Division of Occupational Therapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lana van Niekerk
- grid.11956.3a0000 0001 2214 904XDivision of Occupational Therapy, Department of Health and Rehabilitation Science, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
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John A, Rossettie S, Rafael J, Cox CT, Ducic I, Mackay BJ. Patient-Reported Outcomes and Provocative Testing in Peripheral Nerve Injury and Recovery. J Brachial Plex Peripher Nerve Inj 2023; 18:e10-e20. [PMID: 37089516 PMCID: PMC10121318 DOI: 10.1055/s-0043-1764352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 02/03/2023] [Indexed: 04/25/2023] Open
Abstract
Background Peripheral nerve function is often difficult to assess given the highly variable presentation and subjective patient experience of nerve injury. If nerve assessment is incomplete or inaccurate, inappropriate diagnosis and subsequent treatment may result in permanent dysfunction. Objective As our understanding of nerve repair and generation evolves, so have tools for evaluating peripheral nerve function, recovery, and nerve-related impact on the quality of life. Provocative testing is often used in the clinic to identify peripheral nerve dysfunction. Patient-reported outcome forms provide insights regarding the effect of nerve dysfunction on daily activities and quality of life. Methods We performed a review of the literature using a comprehensive combination of keywords and search algorithms to determine the clinical utility of different provocative tests and patient-reported outcomes measures in a variety of contexts, both pre- and postoperatively. Results This review may serve as a valuable resource for surgeons determining the appropriate provocative testing tools and patient-reported outcomes forms to monitor nerve function both pre- and postoperatively. Conclusion As treatments for peripheral nerve injury and dysfunction continue to improve, identifying the most appropriate measures of success may ultimately lead to improved patient outcomes.
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Affiliation(s)
- Albin John
- Texas Tech University Health Sciences Center, Lubbock, Texas
- Address for correspondence Albin John, MBA Department of Orthopaedic SurgeryTexas Tech University Health Sciences Center, 3601 4th Street, Mail Stop 9436, Lubbock 79430TX
| | | | - John Rafael
- Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Cameron T. Cox
- Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Ivica Ducic
- Washington Nerve Institute, McLean, Virginia
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Basakci Calik B, Demir P, Gur Kabul E, Caglayan BC, Keskin A, Karasu U. Validity and Reliability of the Turkish Version of the DASH-TR Questionnaire in Rheumatoid Arthritis Patients, Based on Rasch Analysis. Int J Rheum Dis 2022; 25:851-860. [PMID: 35665605 DOI: 10.1111/1756-185x.14358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 11/27/2022]
Abstract
AIM This study aimed to examine the validity and reliability of the Turkish version of the Disabilities of the Arm, Shoulder and Hand Problems (DASH-TR) questionnaire in rheumatoid arthritis (RA) using the Rasch analysis. METHOD A total 97 individuals (13 men, 84 women; mean age:51.99 ± 11.12 years, range: 20-65 years) diagnosed as having RA according to the criteria of the American College of Rheumatology were included. The functional status of the upper extremities was evaluated with the DASH-TR questionnaire, patient global health with a visual analog scale (VAS), disease activity with Disease Activity Score 28-C-reactive protein (DAS28-CRP), and disability with Health Assessment Questionnaire (HAQ). DASH-TR was applied to the patients with RA who did not receive any treatment for test-retest at 1-week intervals. DASH-TR results were analyzed using the Rasch analysis. RESULTS In the sample of patients with RA, it was determined that the DASH-TR scale did not provide a unidimensional structure and the items were collected in two dimensions. The first 20 items and the last nine items were differentiated in the two-dimensional structure, and the factor load of m21 was low. Person separation index was obtained as 0.948. Internal consistency reliability was quite high. A significant positive correlation was found between the DASH-TR and VAS, DAS28 and HAQ. There was excellent test-retest reliability according to the intra-class correlation coefficient (0.921, 95% CI 0.882-0.947; P < 0.001). CONCLUSION The DASH-TR is a reliable and valid questionnaire and can be used for measurement of functional status of the upper extremities in RA.
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Affiliation(s)
- Bilge Basakci Calik
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Pervin Demir
- Department of Biostatistics and Medical Informatics, Yıldırım Beyazıt University, Ankara, Turkey
| | - Elif Gur Kabul
- Institute of Health Sciences, Physiotherapy and Rehabilitation, Usak University, Usak, Turkey
| | - Berna Cagla Caglayan
- Faculty of Health Science, Physiotherapy and Rehabilitation, Okan University, Istanbul, Turkey
| | - Aylin Keskin
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Ugur Karasu
- Department of Rheumatology, Medical Faculty of Pamukkale University, Denizli, Turkey
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Doi K, Sem SH, Hattori Y, Sakamoto S, Hayashi K. Psychometric Evaluation of the Disabilities of the Arm, Shoulder and Hand Outcome Questionnaire for Brachial Plexus Injury Using Rasch Analysis. J Hand Surg Asian Pac Vol 2022; 27:285-293. [PMID: 35404203 DOI: 10.1142/s2424835522500230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is the most widely used patient-reported outcome measure (PROM) for assessment of upper extremity disability assessment. However, DASH is a multidimensional measurement with different difficulty levels and ratio apportionment of the items categorised by ordinal scale. This has caused a misinterpretation of the total disability scores. We created a modified DASH adapted to the Rasch model. The aim of this study is to compare the functional recovery and quality of life (QOL) improvement and to assess the validity of the original DASH and modified DASH between C56/C567, C5-8 and total types of brachial plexus injury (BPI) following surgical reconstruction. Methods: A total of 183 BPI patients who underwent reconstructive surgery were evaluated for functional recovery using the range of motion and power of the affected limb, and improvement in QOL with DASH. The collected data were analysed using Rasch measurement theory to detect the misfit items. The original and modified DASH were compared under the three different types of BPI after item reduction by removing the misfit items. Results: There were significant differences in functional recovery between three types of palsy. However, PROM using DASH score with or without misfit items (12 items) did not show any significant differences. Conclusions: DASH is not suitable for comparison of upper extremity disabilities even after being corrected mathematically due to the inclusion of items from many different domains unequally. Therefore, each item of the function (with or without compensation of the uninjured hand), pain and impact to the patients should be evaluated separately. Level of Evidence: Level IV (Prognostic).
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Affiliation(s)
- Kazuteru Doi
- Department of Orthopaedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan
| | - Sei Haw Sem
- Department of Orthopaedics, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Yasunori Hattori
- Department of Orthopaedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan
| | - Sotetsu Sakamoto
- Department of Orthopaedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan
| | - Kota Hayashi
- Department of Orthopaedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan
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Psychometric evaluation of the disabilities of the arm, shoulder and hand (DASH) in patients with orthopedic shoulder impairments seeking outpatient rehabilitation. J Hand Ther 2021; 34:404-414. [PMID: 32291118 DOI: 10.1016/j.jht.2020.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 01/09/2020] [Accepted: 01/12/2020] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN This is a cross-sectional, observational study. INTRODUCTION The disability of the arm, shoulder and hand (DASH) questionnaire is an upper-extremity specific outcome measure commonly used in routine clinical care and clinical trials. PURPOSE OF THE STUDY Our purposes were to: (1) examine the psychometric properties of the DASH questionnaire using factor analysis, one- and two-parameter item response theory models, and (2) develop a functional staging map illustrating the relationships between the item difficulty hierarchy of the DASH items and the patient's DASH total score. METHODS Data from 2724 patients with orthopedic shoulder impairments seeking outpatient physical therapy in 79 clinics in the US were analyzed. RESULTS Factor analysis supported a general factor, explaining 62.2% of the total variance. The coverage of DASH items was suitable for patients with shoulder impairments with no ceiling or floor effect. Endorsed items representing the most difficult items were related to feeling less capable, executing recreational activities with force or impact, and performing recreational activities in which you move your arm freely. Items with higher discriminating abilities were those related to do heavy household chores, garden/yard work, and change a light bulb overhead. With a separation index equaled to 4.94, the DASH can differentiate persons into at least 6 statistically distinct person strata. None of the DASH items exhibited differential item functioning by gender or symptom acuity, except two items by age group. DISCUSSION Besides a total (summed) final score obtained from a specific measure, the keyform and functional staging plots/maps can be used to assist clinicians in clinical interpretation of the scores. CONCLUSIONS Results supported the clinical usage of the DASH questionnaire in patients with orthopedic shoulder impairments seeking outpatient rehabilitation.
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Alnahdi AH. Structural validity of the Arabic version of the disabilities of the Arm, Shoulder and Hand (DASH) using Rasch measurement model. J Patient Rep Outcomes 2021; 5:119. [PMID: 34743235 PMCID: PMC8572284 DOI: 10.1186/s41687-021-00392-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background The disabilities of the arm, shoulder and hand (DASH) is a commonly used region-specific patient-reported outcome measure (PROM) that quantify upper extremity function (activity limitation) and symptoms. Current evidence suggests that measurement properties of the adapted versions of the DASH are not sufficiently examined. The Arabic DASH has evidence supporting its internal consistency, test–retest reliability, construct validity and responsiveness. On the other hand, the validity of the assumed unidimensionality of the Arabic DASH has not been examined previously. The aim of this study was to examine the structural validity of the Arabic DASH in patients with upper extremity musculoskeletal disorders using Rasch measurement model. Methods Patients with upper extremity musculoskeletal disorders were recruited and were asked to complete the Arabic DASH at their initial visit to physical therapy departments. The overall fit of the Arabic DASH to the requirement of the Rasch measurement model was examined using chi-square statistics for item-trait interaction, mean item and person fit residuals. The fit of individual items, thresholds ordering, local dependency, differential item functioning (DIF), and unidimensionality using the t-test approach were also examined. Results The Arabic DASH did not fit the Rasch measurement model initially (χ2 = 179.04, p < 0.001) with major breach of local item independence and a pattern of high residual correlations among the activity-related items and among the impairment-related items. Combining items into activity-limitation and impairment testlets accommodated the local dependency and led to satisfactory fit of the Arabic DASH to the requirement of the Rasch measurement model (χ2 = 3.99, p = 0.41). Conclusions Rasch measurement model supports the structural validity of the Arabic DASH as a unidimensional measure after the accommodation of local dependency.
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Affiliation(s)
- Ali H Alnahdi
- Rehabilitation Sciences Department, College of Applied Medical, Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia.
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Eden MM, Kunze KL, Galantino ML, Kolber MJ, Cheng MS. Shoulder-Specific Patient-Reported Outcome Measures for Use in Patients With Head and Neck Cancer: An Assessment of Reliability, Construct Validity, and Overall Appropriateness of Test Score Interpretation Using Rasch Analysis. Phys Ther 2021; 101:6309594. [PMID: 34174083 DOI: 10.1093/ptj/pzab160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/12/2021] [Accepted: 05/15/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the construct validity and overall appropriateness of test score interpretation of 4 shoulder-related patient-reported outcome (PRO) measures for use in a population of patients with head and neck cancer using Rasch analysis. METHODS One hundred eighty-two individuals who had received a neck dissection procedure within the past 2 weeks to 18 months were recruited for this cross-sectional psychometric study. Rasch methodologies were used to investigate scale dimensionality, scale hierarchy, response scale structure, and reliability of Disabilities of the Arm, Shoulder and Hand (DASH), QuickDASH, Shoulder Pain and Disability Index (SPADI), and Neck Dissection Impairment Index (NDII). RESULTS DASH did not meet criteria for unidimensionality and was deemed inappropriate for use in this sample. The QuickDASH, SPADI, and NDII were all determined to be unidimensional. All scales had varying issues with person and item misfit, differential item functioning, coverage of ability levels, and optimal rating scale requirements. The NDII met most requirements. All measures were found to meet thresholds for person and item separation as well as reliability statistics. CONCLUSIONS Rasch analysis indicates the NDII is the most appropriate measure studied for this population. The QuickDASH and SPADI are recommended with reservation, whereas the DASH is not recommended. IMPACT This study demonstrates the use of objective methodologies, using Rasch analysis, to validate PRO recommendations provided by clinical experts in forums such as the Evaluation Database to Guide Effectiveness (EDGE) TaskForce, which are based upon a comprehensive literature review, consideration of published psychometric properties, and expert consensus. Use of Rasch methodologies demonstrates weaknesses in this model and provides opportunities to strengthen recommendations for clinicians.
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Affiliation(s)
- Melissa M Eden
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Phoenix, Arizona, USA
| | - Katie L Kunze
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, USA
| | - Mary Lou Galantino
- School of Health Sciences, Stockton University, Galloway Township, New Jersey, USA.,School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,School of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Morey J Kolber
- Department of Physical Therapy, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - M Samuel Cheng
- Department of Physical Therapy, Nova Southeastern University, Fort Lauderdale, Florida, USA
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13
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Boe C, Blazar P, Iannuzzi N. Dupuytren Contractures: An Update of Recent Literature. J Hand Surg Am 2021; 46:896-906. [PMID: 34452797 DOI: 10.1016/j.jhsa.2021.07.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 05/28/2021] [Accepted: 07/02/2021] [Indexed: 02/02/2023]
Abstract
Dupuytren disease is a fibroproliferative disorder that affects the palmar fascia of the hand and results in varying degrees of nodule and cord formation. Over time, patients may develop progressive contractures, impairing their ability to type, to perform with fine instruments, or to participate in social activities such as shaking hands. Treatment options for Dupuytren contractures include needle aponeurotomy (NA), injection of collagenase Clostridium histolyticum (CCH) with manipulation of the digits, and surgical fasciectomy. Over the past decade, the use of CCH has increased. Recent studies have provided additional data regarding the pathophysiology, indications, outcomes, and costs associated with the treatment for Dupuytren contractures, and this review highlights these advances.
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Affiliation(s)
- Chelsea Boe
- Department of Orthopaedics & Sports Medicine, University of Washington, Seattle, WA
| | - Philip Blazar
- Section of Hand and Upper Extremity Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Nicholas Iannuzzi
- Department of Orthopaedics & Sports Medicine, University of Washington, Seattle, WA.
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14
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Forget NJ, Higgins J, Rivard M, Harris PG. Going beyond Activity and Participation: Development of the DIF-CHUM-A patient-reported outcome measure for individuals with Dupuytren's contracture. J Hand Ther 2021; 33:305-313. [PMID: 31492480 DOI: 10.1016/j.jht.2019.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 03/27/2019] [Accepted: 03/28/2019] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN This is a cross-sectional clinical measurement. INTRODUCTION There are currently no Dupuytren's contracture (DC)-specific, patient-reported outcomes (PROs) that can provide a thorough clinical portrait of the patients' perceptions with regard to the execution of regular activities. PURPOSE OF THE STUDY The purpose of this study was to present the development of the Dupuytren's contracture Impact on Function-Centre Hospitalier de l'Université de Montréal (DIF-CHUM), a DC-specific PRO. METHODS The development process involved consultation of 45 individuals with DC and 7 health professionals, existing literature, and DC-specific PRO. RESULTS The DIF-CHUM is composed of 2 sections: section 1, Activity and Participation includes 8 items per hand, scored on Difficulty and Change scales; section 2, General Impact includes up to 18 items, scored on Difficulty, Importance, Change and Satisfaction scales. Preliminary evidence suggests that the DIF-CHUM demonstrates good content validity. DISCUSSION The DIF-CHUM is designed to be a patient-centered measure of Activity and Participation and Functional Competence for individuals with DC that will provide hand therapists with a unique perspective of the impact of DC on patients' lives. CONCLUSION Further validation of the DIF-CHUM, including its scoring, is under way.
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Affiliation(s)
- Nancy J Forget
- Public Health PhD Program, School of Public Health, University of Montreal, Montreal, Quebec, Canada.
| | - Johanne Higgins
- School of Rehabilitation, University of Montreal, Montreal, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Michèle Rivard
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada; Public Health Research Institute, University of Montreal, Montreal, Quebec, Canada
| | - Patrick G Harris
- Plastic Surgery Service, Department of Surgery, University of Montreal Hospital Center (CHUM), Montreal, Quebec, Canada
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15
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Uimonen MM, Hulkkonen SM, Ryhänen J, Ponkilainen VT, Häkkinen AH, Karppinen J, Repo JP. Assessment of construct validity of the Finnish versions of the Disabilities of Arm, Shoulder and Hand Instrument and the Michigan Hand Outcomes Questionnaire. J Hand Ther 2021; 33:571-579. [PMID: 31481338 DOI: 10.1016/j.jht.2019.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 03/08/2019] [Accepted: 03/08/2019] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Cross-sectional study. INTRODUCTION There is a lack of information on the measurement properties of patient-reported upper extremity instruments and their association to health-related quality of life (HRQoL). PURPOSE OF THE STUDY This study aimed to examine and compare the measurement properties and construct validity of the Disabilities of Arm, Shoulder, and Hand (DASH) Instrument and the Michigan Hand Questionnaire (MHQ) using a heterogeneous sample of patients with hand and wrist problems. METHODS Two hundred fifty consecutive patients visiting a general orthopedic outpatient clinic due to various hand/wrist problems were invited to participate in the study. A total of 193 (77%) participants provided sufficient patient-reported outcome data and were included in the analysis. Participants completed the DASH, the MHQ, the EQ-5D-3L, and pain on a visual analog scale instruments. Grip and key pinch forces were measured. Scale targeting, relatedness of demographics, and construct validity of the DASH and the MHQ were assessed. RESULTS Both the DASH and the MHQ had good targeting, but the DASH had wider coverage. The convergence between the DASH and the MHQ was high. The DASH was more closely related to HRQoL than the MHQ in terms of EQ-5D scores. DISCUSSION The DASH instrument appeared to measure hand function and disability from a perspective of HRQoL superior to the MHQ among patients with heterogeneous hand and wrist complaints. CONCLUSION The DASH performs well in measuring the HRQoL-related hand outcomes while the MHQ might be more specific for the affected hand.
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Affiliation(s)
- Mikko M Uimonen
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.
| | - Sina M Hulkkonen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jorma Ryhänen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Arja H Häkkinen
- Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Department of Physical Medicine, Central Finland Health Care District, Jyväskylä, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland; Finnish Institute of Occupational Health, Oulu, Finland
| | - Jussi P Repo
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
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16
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Bradet-Levesque I, Audet J, Roy JS, Flamand VH. Measuring functional outcome in Dupuytren's disease: A systematic review of patient-reported outcome measures. J Hand Ther 2021; 35:613-627. [PMID: 34334275 DOI: 10.1016/j.jht.2021.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/16/2021] [Accepted: 04/05/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Functional impairments related to Dupuytren's disease (DD) can be assessed using patient-reported outcome measures (PROMs). A systematic review was published in 2013 on outcome measures for assessing treatment in individuals with DD; however, several articles have since been published on this matter. PURPOSE To conduct a systematic review to analyze the quality and content of the evidence on the psychometric properties of PROMs used in individuals with DD. STUDY DESIGN Systematic review. METHODS CINAHL, EBM reviews, Embase, Medline, and Web of Science were searched to identify studies evaluating the psychometric properties of PROMs used with individuals with DD. All studies retained were appraised by two independent assessors using two validated critical appraisal tools. RESULTS Fifteen articles on the psychometric properties of 10 PROMs were included. Construct validity and responsiveness were the most studied. Eighty percent of the studies were of good to very good methodological quality according to MacDermid's Critical appraisal checklist for psychometric articles, whereas 67% of the studies comported risks of bias according to the COSMIN checklist. Of the 10 PROMs, three were specifically developed for DD but remain mostly under-studied for their psychometric properties (≤ 2 studies for the SDSS and DIF-CHUM). The QuickDASH, MHQ, BriefMHQ, and URAM present moderate to good convergent validity. Test-retest reliability was found to be good for the MHQ, briefMHQ, URAM, SDSS, SF-36, and the multi-attribute of the HUI-3. The MHQ and BriefMHQ are highly responsive. CONCLUSION There is a need for more psychometric studies on the PROMs used with individuals with DD. However, to date, the results included in this systematic review support that the MHQ and briefMHQ are the PROMs with the most acceptable psychometric properties.
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Affiliation(s)
- Isabelle Bradet-Levesque
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada; Cirris, Québec, Québec, Canada
| | - Jessika Audet
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada; Cirris, Québec, Québec, Canada
| | - Jean-Sébastien Roy
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada; Cirris, Québec, Québec, Canada
| | - Véronique H Flamand
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada; Cirris, Québec, Québec, Canada.
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17
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Matsuoka K, Watanabe A, Kawaguchi T, Misawa K, Murakami K, Fukuda M. Development of a New Daily Activities Scale for the Affected Hand after Stroke. Prog Rehabil Med 2020; 5:20200031. [PMID: 33367132 PMCID: PMC7747013 DOI: 10.2490/prm.20200031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/02/2020] [Indexed: 11/21/2022] Open
Abstract
Objectives: There are few scales that reflect the function of the stroke-affected arm as it relates
to the performance of daily activities while also indicating the difficulty of scale
items. In this study, we developed the Activities Specific Upper-extremity Hemiparesis
Scale (ASUHS) to evaluate daily activities performable by the affected arm after stroke.
We also clarified the validity, reliability, and item difficulty of the scale. Methods: The participants were 145 patients with stroke who were consecutively admitted to a
convalescent rehabilitation ward. The unidimensionality of ASUHS was assessed by
principal component analysis. Analyses of item discrimination and content validity were
conducted to assess the overall validity. Reliability was evaluated by assessing
internal consistency and inter-rater reliability. Item difficulties were determined by
Rasch analysis. Results: Unidimensionality, high discrimination, and good content validity were shown for all
items. ASUHS consists of a dominant hand scale and non-dominant hand scale. Both scales
showed good internal consistency (Cronbach’s α coefficient = 0.99) and substantial
inter-rater reliability (Cohen’s Kappa coefficient = 0.74 and 0.75, respectively). Item
difficulty was determined as being in the range –8.71 to +5.18 logit. Conclusions: This study suggested good validity and reliability of ASUHS. Furthermore, because the
item difficulties of daily activities performed by the affected arm were clarified,
therapists can use ASUHS to identify the process that should be the next focus for
training. Consequently, therapists may be able to train patients in daily activities
that match the affected arm’s ability step by step rather than determining training
activities empirically.
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Affiliation(s)
- Koshi Matsuoka
- Department of Rehabilitation Medicine, Tamakyuryo Hospital, Machida, Japan.,Graduate School of Medical Science, Kitasato University, Sagamihara, Japan
| | - Aki Watanabe
- Graduate School of Medical Science, Kitasato University, Sagamihara, Japan.,Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Takayuki Kawaguchi
- Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Koji Misawa
- Department of Rehabilitation Medicine, Tamakyuryo Hospital, Machida, Japan
| | - Keiichi Murakami
- Department of Rehabilitation Medicine, Tamakyuryo Hospital, Machida, Japan
| | - Michinari Fukuda
- Graduate School of Medical Science, Kitasato University, Sagamihara, Japan.,Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
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18
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Ikonen J, Hulkkonen S, Ryhänen J, Häkkinen A, Karppinen J, Repo JP. The structural validity of the Finnish version of the Disabilities of the Arm, Shoulder and Hand: A Rasch model analysis. HAND THERAPY 2020. [DOI: 10.1177/1758998320907116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Introduction The construct validity of the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) has previously been questioned. The purpose of this study was to evaluate the measurement properties of the Finnish version of the DASH for assessing disability in patients with hand complaints using Rasch Measurement Theory. Methods A cohort of 193 patients with typical hand and wrist complaints were recruited at a surgery outpatient clinic. The DASH scores were analysed using the Rasch model for differential item functioning, unidimensionality, fit statistics, item residual correlation, coverage/targeting and reliability. Results In the original DASH questionnaire, the item response thresholds were disordered for 2 of 30 of the items. The item fit was poor for 9 of 30 of the items. Unidimensionality was not supported. There was substantial residual correlation between 87 pairs of items. Item reduction (chi square 95, degrees of freedom 50, p < 0.001) and constructing two testlets led to unidimensionality (chi square 0.64, degrees of freedom 4, p = 0.96). Person separation index was 0.95. The testlets had good fit with no differential item functioning towards age or gender. Conclusion Unidimensionality of the original Finnish version of the DASH was not supported, meaning the questionnaire seems to gauge traits other than disability alone. Hence, the clinician must be careful when trying to measure change in patients’ scores. Item reduction or the creation of testlets did not lead to good alternatives for the original Finnish DASH. Differential item functioning showed that the original Finnish scale exhibits minor response bias by age in one item. The original Finnish DASH covers different levels of ability well among typical hand surgery patients.
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Affiliation(s)
- J Ikonen
- Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland
- Department of Hand Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - S Hulkkonen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - J Ryhänen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - A Häkkinen
- Faculty of Sports and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - J Karppinen
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Finnish Institute of Occupational Health, Oulu, Finland
| | - JP Repo
- Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland
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Abstract
Nowadays, the use of patient-reported outcome measures to monitor a treatment effect in daily practice or to quantify study outcomes is indispensable. In hand surgery, there is a wide variety available. This article provides an overview about the most common hand-specific, upper-extremity specific and general quality of life patient-reported outcome measurement instruments with adequate psychometric properties. A checklist and a decision tree are provided for choosing the appropriate instrument when evaluating patients with hand conditions.
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Affiliation(s)
- Miriam Marks
- Department of Teaching, Research and Development, Schulthess Klinik, Zurich, Switzerland
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20
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Lloyd-Hughes H, Geoghegan L, Rodrigues J, Peters M, Beard D, Price A, Jain A. Systematic Review of the Use of Patient Reported Outcome Measures in Studies of Electively-Managed Hand Conditions. J Hand Surg Asian Pac Vol 2019; 24:329-341. [PMID: 31438799 DOI: 10.1142/s2424835519500425] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Electively-managed conditions account for over 100 000 inpatient surgeries a year in the English National Health Service alone, with further procedures in other regions of the UK, or performed on an outpatient basis. To quality assure this care and to conduct research, effective outcome measurement is critical. Traditional surgeon-centric outcome measures correlate poorly with hand function and are seldom important to patients. There has been an advent in the use of patient reported outcome measures (PROMs) in hand surgery although consensus of PROM choice appears to be lacking. This systematic review aimed to describe the use of relevant PROMs in clinical research of electively-managed hand conditions. Methods: A PRISMA-compliant methodology was used. A bespoke search strategy was developed in conjunction with a search strategist, and applied to Medline, EMBASE, CINAHL and PSYCHINFO from 1992 to June 2017. Pre-specified stepwise inclusion criteria were used to identify studies describing adult patients undergoing treatment for electively-managed hand conditions distal to the distal radius, with clinical outcomes measured using one or more PROMs. Results: Of 4554 results, 834 met inclusion criteria. PROMs identified included 9 disease-specific, 8 site-specific and 4 generic quality of life measures. Across all, the Disabilities of the Arm, Shoulder and Hand (DASH) was the most commonly used (overall frequency 41.0%). The most commonly reported disease-specific measure was the Boston Carpal Tunnel Questionnaire (overall frequency 23.0%). The most commonly reported generic quality of life of measure was the SF-36 (overall frequency 4%). Time-analysis demonstrated predominance of site-specific PROMs since the year 2000. Conclusions: Various PROMs have been used to study electively-managed hand conditions, with site-specific PROMs most popular. However, there appears to be limited consensus on choices. A future systematic evaluation of the published psychometric properties of identified PROMs may inform standardisation of measurement.
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Affiliation(s)
- Hawys Lloyd-Hughes
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Luke Geoghegan
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Jeremy Rodrigues
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Michele Peters
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - David Beard
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Andrew Price
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Abhilash Jain
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
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21
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Factor Structure of the Disabilities of the Arm, Shoulder and Hand Questionnaire in Upper Extremity Nerve Injury. Plast Reconstr Surg 2019; 144:1116-1122. [DOI: 10.1097/prs.0000000000006151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Site-specific Patient-reported Outcome Measures for Hand Conditions: Systematic Review of Development and Psychometric Properties. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2256. [PMID: 31333975 PMCID: PMC6571349 DOI: 10.1097/gox.0000000000002256] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 03/18/2019] [Indexed: 12/26/2022]
Abstract
Background There are a number of site-specific patient-reported outcome measures (PROMs) for hand conditions used in clinical practice and research for assessing the efficacy of surgical and nonsurgical interventions. The most commonly used hand-relevant PROMs are as follows: Disabilities of the Arm, Shoulder and Hand (DASH), QuickDASH (qDASH), Michigan Hand Questionnaire (MHQ), Patient Evaluation Measure (PEM), Upper Extremity Functional Index (UEFI), and Duruoz Hand Index (DHI). There has been no systematic evaluation of the published psychometric properties of these PROMs. Methods A PRISMA-compliant systematic review of the development and validation studies of these hand PROMs was prospectively registered in PROSPERO and conducted to assess their psychometric properties. A search strategy was applied to Medline, Embase, PsycINFO, and CINAHL. Abstract screening was performed in duplicate. Assessment of psychometric properties was performed. Results The search retrieved 943 articles, of which 54 articles met predefined inclusion criteria. There were 19 studies evaluating DASH, 8 studies evaluating qDASH, 13 studies evaluating MHQ, 5 studies evaluating UEFI, 4 studies evaluating PEM, and 5 studies evaluating DHI. Assessment of content validity, internal consistency, construct validity, reproducibility, responsiveness, floor/ceiling effect, and interpretability for each PROM is described. Conclusions The psychometric properties of the most commonly used PROMs in hand research are not adequately described in the published literature. DASH, qDASH, and MHQ have the best-published psychometric properties, though they have either some poor psychometric performance or incompletely studied psychometric properties. There are more limited published data describing the psychometric properties of the UEFI, PEM, and DHI.
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23
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Higgins J, Laramée MT, Harrison KR, Delparte JJ, Scovil CY, Flett HM, Burns AS. The Spinal Cord Injury Pressure Ulcer Scale (SCIPUS): an assessment of validity using Rasch analysis. Spinal Cord 2019; 57:874-880. [PMID: 31053776 DOI: 10.1038/s41393-019-0287-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Secondary analysis of retrospective data. OBJECTIVE The aim of this study was to further validate the Spinal Cord Injury Pressure Ulcer Scale (SCIPUS) using Rasch analysis. SETTING Two rehabilitation centers in Canada. METHOD Data were collected as part of the Spinal Cord Injury Knowledge Mobilization Network (SCI KMN) initiative. The SCIPUS was completed within 72 h of inpatient admission. Persons admitted for initial rehabilitation in two inpatient spinal cord rehabilitation programs were included in the project. RESULTS Data from 886 participants were analyzed, approximately 60% of whom were males. Rasch analyses demonstrated that the SCIPUS, in its current format did not meet criteria required for true measurement. A transformed version of the SCIPUS obtained by deletion of misfitting items and modification of the response scales improved fit to the model and showed preliminary evidence of unidimensionality. The person separation index, however indicated that the scale requires further adjustments of its scoring options. CONCLUSIONS In its original form, the SCIPUS does not meet the requirements of the Rasch model and its total score should be used cautiously. However, following some adjustments to the items such as addressing DIF between sites to insure a standardized assessment across sites and adding response options to some of the items, interval-scale measurement should be possible.
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Affiliation(s)
- Johanne Higgins
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada. .,Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal, Montreal, QC, Canada. .,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
| | - Marie-Thérèse Laramée
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada.,Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal, Montreal, QC, Canada
| | - Kate Rousseau Harrison
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada.,Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) of the Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal, Montreal, QC, Canada
| | - Jude J Delparte
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Carol Y Scovil
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Heather M Flett
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Anthony S Burns
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Division of Physiatry, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Kc S, Sharma S, Ginn K, Almadi T, Subedi H, Reed D. Cross-cultural adaptation and measurement properties of the Nepali version of the DASH (disability of arm, shoulder and hand) in patients with shoulder pain. Health Qual Life Outcomes 2019; 17:51. [PMID: 30898138 PMCID: PMC6429798 DOI: 10.1186/s12955-019-1105-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 02/07/2019] [Indexed: 11/25/2022] Open
Abstract
Background Patient-reported outcome measures (PROMs) are important tools in both clinical practice and research. However, no upper extremity PROM to assess physical disability is available in Nepali. The most commonly used and recommended questionnaire for the shoulder is the Disability of Arm, Shoulder and Hand (DASH). Therefore, the aim of the study was to translate and cross-culturally adapt the DASH into Nepali and determine its measurement properties. Methods The translation and cultural adaptation process followed international standard procedures. The translated Nepali version of the questionnaire (DASH-NP) was completed by 156 patients with shoulder pain from three Nepali hospitals at an initial assessment and by 121 at follow-up. A Nepali version of Global Rating of Change (GROC-NP) was completed at follow-up to dichotomise improved and stable participants. Measurement properties testing included: internal consistency (Cronbach's alpha), test-retest reliability (Intraclass Correlation Coefficient, ICC), Minimal Detectable Change (MDC), construct validity - factor analysis, hypothesis testing with the Shoulder Pain and Disability Index (SPADI) (Pearson Correlation = r) and responsiveness - Area Under the Curve with minimal important change. Results Significant adaptations such as changing measurement units, activities and terminology were incorporated to improve cultural relevance. Internal consistency (α = 0.92) and test-retest reliability (ICC = 0.97, 95% CI: 0.94–0.98, p < 0.001) were excellent. The MDC was 11 out of 100 points. There were moderate-high positive correlations with the SPADI pain and disability items (rs = 0.63 and 0.81, P < 0.001). Four factor solution was retrieved for the DASH-NP. The Area Under the Curve was 0.69 (95% CI: 0.57 - 0.81, p < 0.001) with minimal important change of 11.2/100 points. Conclusions The Nepali translation of the DASH is comprehensible, easy to administer via self-report or interview. It is found to be a reliable, valid, and responsive measure in patients with shoulder pain in Nepal. The DASH-NP can be used to assess shoulder pain related disability in Nepal for clinical practice or research. Electronic supplementary material The online version of this article (10.1186/s12955-019-1105-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sudarshan Kc
- Discipline of Biomedical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Saurab Sharma
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal. .,Center for Musculoskeletal Outcomes Research, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
| | - Karen Ginn
- Discipline of Anatomy & Histology, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Tawfiq Almadi
- Discipline of Biomedical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Hari Subedi
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Darren Reed
- Discipline of Biomedical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Abstract
Dupuytren's disease (DD) is a common fibrotic disorder of the hand and can significantly impair hand function. Although the exact pathogenesis of this disorder remains to be elucidated, immunological, genetic and cellular factors likely interact. In this review, we summarise recent advances in the understanding of DD pathogenesis and look to the future for potential novel therapeutic targets. In addition, we discuss the therapeutic options in DD with a focus on the need for more rigorous evidence to allow a meaningful comparison of different treatment modalities.
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Affiliation(s)
- Thomas Layton
- The Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Jagdeep Nanchahal
- The Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Prodinger B, Hammond A, Tennant A, Prior Y, Tyson S. Revisiting the disabilities of the arm, shoulder and hand (DASH) and QuickDASH in rheumatoid arthritis. BMC Musculoskelet Disord 2019; 20:41. [PMID: 30683082 PMCID: PMC6347833 DOI: 10.1186/s12891-019-2414-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 01/09/2019] [Indexed: 11/29/2022] Open
Abstract
Background Limitations in upper limb functioning are common in Musculoskeletal disorders and the Disabilities of the Arm, Shoulder and Hand scale (DASH) has gained widespread use in this context. However, various concerns have been raised about its construct validity and so this study seeks to examine this and other psychometric aspects of both the DASH and QuickDASH from a modern test theory perspective. Methods Participants in the study were eligible if they had a confirmed diagnosis of Rheumatoid Arthritis (RA). They were mailed a questionnaire booklet which included the DASH. Construct validity was examined by fit to the Rasch measurement model. The degree of precision of both the DASH and QuickDASH were considered through their Standard Error of Measurement (SEM). Results Three hundred and thirty-seven subjects with confirmed RA took part, with a mean age of 62.0 years (SD12.1); 73.6% (n = 252) were female. The median standardized score on the DASH was 33 (IQR 17.5–55.0). Significant misfit of the DASH and QuickDASH was observed but, after accommodating local dependency among items in a two-testlet solution, satisfactory fit was obtained, supporting the unidimensionality of the total sets and the sufficiency of the raw (ordinal or standardized) scores. Conclusion Having accommodated local response dependency in the DASH and QuickDASH item sets, their total scores are shown to be valid, given they satisfy the Rasch model assumptions. The Rasch transformation should be used whenever all items are used to calculate a change score, or to apply parametric statistics within an RA population. Significance and innovations Most previous modern psychometric analyses of both the DASH and QuickDASH have failed to fully address the effect of a breach of the local independence assumption upon construct validity. Accommodating this problem by creating ‘super items’ or testlets, removes this effect and shows that both versions of the scale are valid and unidimensional, as applied with a bi-factor equivalent solution to an RA population. The Standard Error of Measurement of a scale can be biased by failing to take into account the local dependency in the data which inflates reliability and thus making the SEM appear better (i.e. smaller) than the true value without bias.
Electronic supplementary material The online version of this article (10.1186/s12891-019-2414-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- B Prodinger
- Swiss Paraplegic Research, Nottwil, Switzerland. .,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland. .,ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland. .,Faculty of Applied Health and Social Sciences, Technical University of Applied Sciences Rosenheim, Rosenheim, Germany.
| | - A Hammond
- Centre for Health Sciences Research, School of Health and Society, University of Salford, Salford, UK
| | - A Tennant
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.,ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland
| | - Y Prior
- Centre for Health Sciences Research, School of Health and Society, University of Salford, Salford, UK.,Mid Cheshire NHS Trust Foundation Hospitals, Leighton Hospital, Crewe, UK
| | - S Tyson
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
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27
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Broekstra DC, van den Heuvel ER, Lanting R, Werker PMN. Measurement properties of the Dutch Unité Rhumatologique des Affections de la Main and its ability to measure change due to Dupuytren's disease progression compared with the Michigan Hand outcomes Questionnaire. J Hand Surg Eur Vol 2018; 43:855-863. [PMID: 29439589 PMCID: PMC6139982 DOI: 10.1177/1753193417752891] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED Data of a prospective longitudinal cohort study including 233 Dupuytren's patients was used to determine: (1) whether the Unité Rhumatologique des Affections de la Main scale and Michigan Hand outcomes Questionnaire can detect change in hand function due to Dupuytren's disease progression and to compare their abilities; (2) the concurrent validity, reliability, responsiveness and interpretability of the Dutch Unité Rhumatologique des Affections de la Main. The Unité Rhumatologique des Affections de la Main and Michigan Hand outcomes Questionnaire had comparable measurement properties, and were both able to distinguish participants with disease progression from those without progression (resp. U = 1252.5, p = 0.008, and U = 1086.0, p < 0.001), but only at a group level. Individual cases of progression could not be detected using these outcome measures, as indicated by the fact that the smallest detectable change was larger than the minimal important change, and area under the receiver operating curve (AUC) values of 0.75 for Michigan Hand outcomes Questionnaire and 0.67 for Unité Rhumatologique des Affections de la Main. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Dieuwke C. Broekstra
- University of Groningen, University
Medical Center Groningen, Department of Plastic Surgery, Groningen, The
Netherlands,Dieuwke C. Broekstra, Department of Plastic
Surgery BB81, University Medical Center Groningen, PO Box 30.001, 9700 RB
Groningen, The Netherlands.
| | - Edwin R. van den Heuvel
- Eindhoven University of Technology,
Department of Mathematics and Computer Science, Eindhoven, The Netherlands
| | - Rosanne Lanting
- University of Groningen, University
Medical Center Groningen, Department of Plastic Surgery, Groningen, The
Netherlands
| | - Paul M. N. Werker
- University of Groningen, University
Medical Center Groningen, Department of Plastic Surgery, Groningen, The
Netherlands
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28
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Abstract
The role of hand therapy in the treatment of Dupuytren disease varies depending on the patient and the procedure. There is limited evidence for hand therapy as a preventive treatment of Dupuytren disease. Before corrective treatment, the hand therapist can contribute with assessments to promote evaluation of outcome. After corrective treatment, hand therapy is tailored to each patient's needs and consists of orthoses, exercise, edema control, and pain or scar management. Orthoses are usually part of the hand therapy protocol after corrective procedures despite lack of strong supporting evidence and should be provided based on individual patient needs.
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Affiliation(s)
- Christina Turesson
- Department of Hand Surgery, Plastic Surgery and Burns, Linköping University Hospital, Linköping University, Linköping 581 85, Sweden; Department of Social and Welfare Studies, Linköping University, Kungsgatan 40, Norrköping 60174, Sweden.
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29
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Abstract
Despite more than a hundred years of publications on Dupuytren disease, there has been a lack of consensus on definitions and outcomes until recently. Staging and classifications systems have an important historical context; however, more recently, outcomes rely on patient-reported outcomes, angular correction, and definitions of recurrence. This article reviews commonly used assessments, classifications, and staging systems for Dupuytren disease.
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30
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Wajngarten D, Campos JADB, Botta AC, Nordi Sasso Garcia PP. Validity and reliability of the Disabilities of Arm, Shoulder, and Hand scale in dental students: A transnational study. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2018; 73:258-266. [PMID: 28489519 DOI: 10.1080/19338244.2017.1328384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 05/05/2017] [Indexed: 06/07/2023]
Abstract
This study aimed to evaluate the validity and reliability of the Disabilities of Arm, Shoulder, and Hand (DASH) scale in Brazilian and American dental students and assess the influence of demographic variables on disability in them. A cross-sectional observational study was conducted with a nonprobabilistic sample. The sample was composed of students of both genders from the School of Dentistry of Araraquara, State University of São Paulo (UNESP) (n = 288), and students from Stony Brook University, New York, NY, USA (n = 149). The disabilities of the upper limbs were estimated using the DASH scale. The samples were characterized by collecting information on gender, academic year, and sports and work activities. The refined bifactorial model presented goodness-of-fit indices for both countries. There was a significant effect of the variables gender and academic year for the Brazilian sample and the variable sports practices for the American sample. The refined bifactorial model was valid and reliable for the Brazilian and American populations. In this model, the removal of item 17 for the Brazilian sample and items 3, 13, and 23 for the American sample was necessary. Demographic variables such as gender, academic year, and sports practice contributed significantly to the level of disability in the study populations.
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Affiliation(s)
- Danielle Wajngarten
- a Araraquara Dental School , Universidade Estadual Paulista (UNESP), Araraquara , São Paulo , Brazil
| | - Juliana Alvares Duarte Bonini Campos
- b Department of Food and Nutrition , Araraquara College of Pharmaceutical Sciences, Universidade Estadual Paulista, Araraquara (UNSEP) , São Paulo , Brazil
| | - Ana Carolina Botta
- c Department of General Dentistry , Stony Brook School of Dental Medicine , New York , New York , USA
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31
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Hung M, Voss MW, Bounsanga J, Gu Y, Granger EK, Tashjian RZ. Psychometrics of the Patient-Reported Outcomes Measurement Information System Physical Function instrument administered by computerized adaptive testing and the Disabilities of Arm, Shoulder and Hand in the orthopedic elbow patient population. J Shoulder Elbow Surg 2018; 27:515-522. [PMID: 29325704 PMCID: PMC5811400 DOI: 10.1016/j.jse.2017.10.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/09/2017] [Accepted: 10/18/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND This study evaluated the psychometric properties of the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) instrument administered through computerized adaptive testing (CAT) compared with the traditional full-length Disabilities of the Arm, Shoulder and Hand (DASH). METHODS The PROMIS PF CAT and the DASH were administered to 1759 patients seeking care for elbow conditions. This study used Rasch partial credit modeling to analyze the instruments with item fit, internal reliability, response category thresholds, dimensionality, local independence, gender differential item functioning, and floor and ceiling effects. RESULTS The PROMIS PF CAT and DASH had satisfactory item fit for all but 1 item on both measures. Internal reliabilities were high for both measures. Two items on the DASH and 4 items on the PF CAT showed nonordered category thresholds. Unidimensionality was adequate, and local independence was supported for both instruments. Gender bias was found for 4 items on the PF CAT and 12 items on the DASH. Both measures had adequate instrument targeting and satisfactory floor and ceiling effects. CONCLUSION The PROMIS PF CAT and the DASH both showed sufficient unidimensionality, good item fit, and good local independence with the exception of high levels of gender item bias, particularly for the DASH. Further scale evaluation should address item bias and item response categories for these instruments. Overall, the PROMIS PF CAT is an effective outcome instrument to measure function in patients with elbow disorders that requires significantly fewer questions than the DASH.
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Affiliation(s)
- Man Hung
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, UT, USA.
| | - Maren W Voss
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, UT, USA
| | - Jerry Bounsanga
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, UT, USA
| | - Yushan Gu
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, UT, USA
| | - Erin K Granger
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, UT, USA
| | - Robert Z Tashjian
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, UT, USA
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32
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Wormald JCR, Rodrigues JN. Outcome measurement in plastic surgery. J Plast Reconstr Aesthet Surg 2017; 71:283-289. [PMID: 29233505 DOI: 10.1016/j.bjps.2017.11.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/11/2017] [Accepted: 11/09/2017] [Indexed: 01/14/2023]
Abstract
Outcome measurement in plastic surgery is often surgeon-centred, and clinician-derived. Greater emphasis is being placed on patient-reported outcomes (PROs), in which the patients' perspective is measured directly from them. Numerous patient-reported outcome measures (PROMs) have been developed in a range of fields, with a number of good quality PROMs in plastic surgery. They can be deployed to support diagnosis, disease severity determination, referral pathways, treatment decision-making, post-operative care and in determining cost-effectiveness. In order to understand the impact of disease and health interventions, appropriate PROMs are a logical choice in plastic surgery, where many conditions involve detriment of function or cosmesis. PROMS can be classified as disease-specific, domain-specific, dimension-specific, population-specific and generic. Choosing the correct outcome and measure can be nebulous. The two most important considerations are: is it suitable for the intended purpose? And how valid is it? Measurement that combines being patient-centred and aligning with clinicians' understanding is achievable, and can be studied scientifically. Rational design of new PROMs and considered choice of measures is critical in clinical practice and research. There are a number of tools that can be employed to assess the quality of PROMs that are outlined in this overview. Clinicians should consider the quality of measures both in their own practice and when critically appraising evidence. This overview of outcome measurement in plastic surgery provides a tool set enabling plastic surgeons to understand, implement and analyse outcome measures across clinical and academic practice.
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Affiliation(s)
- Justin C R Wormald
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Nuffield Orthopaedic Centre, Windmill Road, Oxford, UK
| | - Jeremy N Rodrigues
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Nuffield Orthopaedic Centre, Windmill Road, Oxford, UK.
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33
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Iordens GIT, Den Hartog D, Tuinebreijer WE, Eygendaal D, Schep NWL, Verhofstad MHJ, Van Lieshout EMM. Minimal important change and other measurement properties of the Oxford Elbow Score and the Quick Disabilities of the Arm, Shoulder, and Hand in patients with a simple elbow dislocation; validation study alongside the multicenter FuncSiE trial. PLoS One 2017; 12:e0182557. [PMID: 28886018 PMCID: PMC5590744 DOI: 10.1371/journal.pone.0182557] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 07/19/2017] [Indexed: 11/19/2022] Open
Abstract
Study design Validation study using data from a multicenter, randomized, clinical trial (RCT). Objectives To evaluate the reliability, validity, responsiveness, and minimal important change (MIC) of the Dutch version of the Oxford Elbow Score (OES) and the Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) in patients with a simple elbow dislocation. Background Patient-reported outcome measures are increasingly important for assessing outcome following elbow injuries, both in daily practice and in clinical research. However measurement properties of the OES and Quick-DASH in these patients are not fully known. Methods OES and Quick-DASH were completed four times until one year after trauma. Mayo Elbow Performance Index, pain (VAS), Short Form-36, and EuroQol-5D were completed for comparison. Data of a multicenter RCT (n = 100) were used. Internal consistency was determined using Cronbach’s alpha. Construct and longitudinal validity were assessed by determining hypothesized strength of correlation between scores or changes in scores, respectively, of (sub)scales. Finally, floor and ceiling effects, MIC, and smallest detectable change (SDC) were determined. Results OES and Quick-DASH demonstrated adequate internal consistency (Cronbach α, 0.882 and 0.886, respectively). Construct validity and longitudinal validity of both scales were supported by >75% correctly hypothesized correlations. MIC and SDC were 8.2 and 12.0 point for OES, respectively. For Quick-DASH, these values were 11.7 and 25.0, respectively. Conclusions OES and Quick-DASH are reliable, valid, and responsive instruments for evaluating elbow-related quality of life. The anchor-based MIC was 8.2 points for OES and 11.7 for Quick-DASH.
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Affiliation(s)
- Gijs I. T. Iordens
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dennis Den Hartog
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wim E. Tuinebreijer
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Denise Eygendaal
- Department of Orthopaedic Surgery, Upper Limb Unit, Amphia Hospital, Breda, The Netherlands
| | - Niels W. L. Schep
- Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Michael H. J. Verhofstad
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Esther M. M. Van Lieshout
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- * E-mail:
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Rasch Model Analysis Gives New Insights Into the Structural Validity of the QuickDASH in Patients With Musculoskeletal Shoulder Pain. J Orthop Sports Phys Ther 2017; 47:664-672. [PMID: 28704620 DOI: 10.2519/jospt.2017.7288] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Cross-sectional secondary analysis of a prospective cohort study. Background The shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) is a widely used outcome measure that has been extensively evaluated using classical test theory. Rasch model analysis can identify strengths and weaknesses of rating scales and goes beyond classical test theory approaches. It uses a mathematical model to test the fit between the observed data and expected responses and converts ordinal-level scores into interval-level measurement. Objective To test the structural validity of the QuickDASH using Rasch analysis. Methods A prospective cohort study of 1030 patients with shoulder pain provided baseline data. Rasch analysis was conducted to (1) assess how the QuickDASH fits the Rasch model, (2) identify sources of misfit, and (3) explore potential solutions to these. Results There was evidence of multidimensionality and significant misfit to the Rasch model (χ2 = 331.09, P<.001). Two items had disordered threshold responses with strong floor effects. Response bias was detected in most items for age and sex. Rescoring resulted in ordered thresholds; however, the 11-item scale still did not meet the expectations of the Rasch model. Conclusion Rasch model analysis on the QuickDASH has identified a number of problems that cannot be easily detected using traditional analyses. While revisions to the QuickDASH resulted in better fit, a "shoulder-specific" version is not advocated at present. Caution needs to be exercised when interpreting results of the QuickDASH outcome measure, as it does not meet the criteria for interval-level measurement and shows significant response bias by age and sex. J Orthop Sports Phys Ther 2017;47(9):664-672. Epub 13 Jul 2017. doi:10.2519/jospt.2017.7288.
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Difference in Success Treating Proximal Interphalangeal and Metacarpophalangeal Joints with Collagenase: Results of 208 Treatments. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1275. [PMID: 28507849 PMCID: PMC5426868 DOI: 10.1097/gox.0000000000001275] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 02/01/2017] [Indexed: 12/01/2022]
Abstract
Background: Dupuytren disease (DD) is a fibroproliferative disorder of the palmar fasciae causing extension deficit and impaired hand function. Treatment with injection of collagenase clostridium histolyticum (CCH) is a nonsurgical treatment method. The aim of this study was to evaluate the difference in efficiency and recurrence at 12-month follow-up when treating metacarpophalangeal (MP) and proximal interphalangeal (PIP) joints with CCH. None of the patients had received previous treatments of their condition. Methods: This study is a prospective study of a consecutive series of patients with DD presenting with an extension deficit greater than 20° affecting the MP or PIP joint. Results: We found a mean reduction in extension deficit of 47° (91%) for MP joints and 47° (76%) for PIP joints. Full correction (max 5° deficit) was achieved in 76% of MP and 28% of PIP joints. Skin rupture was seen in 34% of treatments. The 1-year relapse rate was 15% for MP and 67% for PIP joints. The reduction in quickDASH score was only statistically significant for MP joints at 1 year. Eighty-one percent of all patients reported being satisfied or very satisfied. No major adverse events were recorded. Conclusion: Excellent results can be achieved in the treatment of MP-joint contractures, whereas the success rate is significantly lower and recurrence rate is greater for PIP joints.
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Packham TL, Ball PD, MacDermid JC, Bain JR, DalCin A. A scoping review of applications and outcomes of traction orthoses and constructs for the management of intra-articular fractures and fracture dislocations in the hand. J Hand Ther 2017; 29:246-68. [PMID: 27496982 DOI: 10.1016/j.jht.2016.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 02/02/2016] [Accepted: 04/08/2016] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Intra-articular hand fractures can have devastating consequences for movement and function. The unique nature of the injury and diverse management strategies are a challenge for conducting trials. PURPOSE OF THE STUDY To conduct a scoping review of traction constructs for the management of intra-articular hand fractures. METHODS We conducted a systematic search of the literature, extracting data on the scope and nature of the evidence for traction constructs. RESULTS Our search yielded 87 articles addressing 3 traction constructs: (1) static traction (n = 17), (2) dynamic external fixation (n = 53), and (3) dynamic orthoses (n = 17). Active range of motion of the target joint was the most frequently reported outcome. Study designs included 36 cohorts, 21 case series, and 9 case studies: 24% contained only technical information. CONCLUSIONS The current literature addressing traction constructs consists primarily of small and low-quality studies. Evidence synthesis could improve the estimation of range of motion outcomes but would not be able to identify the best treatment. Consensus on classification of fracture patterns, routine use of outcome measures, and randomized trials are needed to compare different traction constructs and inform evidence-based care. STUDY DESIGN Scoping review. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
- Tara L Packham
- Hand Therapy Clinic, Department of Rehabilitation Services, Neurosciences and Trauma Program, Hamilton Health Sciences, Hamilton, Ontario, Canada; School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| | - Pamela D Ball
- Hand Therapy Clinic, Department of Rehabilitation Services, Neurosciences and Trauma Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Joy C MacDermid
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - James R Bain
- Department of Surgery, Hamilton Health Sciences, Hamilton, Ontario, Canada; Faculty of Health Sciences, Department of Surgery and Division of Plastic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Arianna DalCin
- Department of Surgery, Hamilton Health Sciences, Hamilton, Ontario, Canada; Faculty of Health Sciences, Department of Surgery and Division of Plastic Surgery, McMaster University, Hamilton, Ontario, Canada
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Rodrigues JN, Zhang W, Scammell BE, Davidson D, Fullilove S, Chakrabarti I, Russell PG, Davis TRC. Recovery, responsiveness and interpretability of patient-reported outcome measures after surgery for Dupuytren's disease. J Hand Surg Eur Vol 2017; 42:301-309. [PMID: 27872343 DOI: 10.1177/1753193416677712] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED This prospective cohort study investigated the responsiveness and interpretability of the Disabilities of the Arm, Shoulder and Hand (DASH) and Unité Rhumatologique des Affections de la Main (URAM) outcome measures for assessing recovery after fasciectomy and dermofasciectomy for Dupuytren's disease. DASH outcome scores at 1 year were significantly better than at 6 weeks, suggesting that recovery is not complete by 6 weeks. Of the 101 patients recruited to the DASH cohort, 71 completed preoperative, 6 week and 1 year postoperative DASH scores; 68 of them completed preoperative and 1 year postoperative DASH scores and an external anchor question. In the URAM cohort, 30/44 completed the preoperative and the 1 year postoperative URAM scores and the anchor question. The DASH score exhibited moderate responsiveness but poor interpretability on receiver operating characteristic curve analysis, such that a minimal important change could not be estimated. The URAM score showed acceptable responsiveness, and an MIC of 10.5 on receiver operating characteristic analysis. LEVEL OF EVIDENCE II.
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Affiliation(s)
- J N Rodrigues
- 1 Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - W Zhang
- 2 Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham & Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - B E Scammell
- 2 Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham & Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - D Davidson
- 3 St John's Hospital at Howden, Livingston, UK
| | | | | | - P G Russell
- 6 Pulvertaft Hand Centre, Royal Derby Hospital, Derby, UK
| | - T R C Davis
- 2 Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham & Nottingham University Hospitals NHS Trust, Nottingham, UK
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Ohshita N, Kanazumi M, Tsuji K, Yoshida H, Morita S, Momota Y, Tsutsumi YM. Anesthetic Management of a Patient With Ehlers-Danlos Syndrome. Anesth Prog 2016; 63:204-207. [PMID: 27973938 DOI: 10.2344/16-00003.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
We describe the case of a 37-year-old woman who had been diagnosed with Ehlers-Danlos syndrome (EDS) 4 years earlier and was scheduled to undergo removal of synovial chondromatosis in the temporomandibular joint. EDS is a heritable connective tissue disorder and has 6 types. In this case, the patient was classified into EDS hypermobility type. The major clinical feature of this type is joint hypermobility. The patient had sprain or subluxation of the elbows and ankles and dislocation of the knees. Anticipated problems during general anesthesia would be affected by the disease type. For this patient, extra attention was directed to positional injury-induced neuropathy and articular luxation, cutaneous injuries, injuries related to intubation and ventilation, and postoperative pain. Anesthesia was induced with propofol, remifentanil, and rocuronium and maintained with oxygen-air-desflurane, propofol, remifentanil, fentanyl, and rocuronium. In this case, the patient was safely managed without adverse events.
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Affiliation(s)
- Naohiro Ohshita
- Department of Anesthesiology, Osaka Dental University, Osaka, Japan
| | | | - Kaname Tsuji
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan
| | - Hiroaki Yoshida
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan
| | - Shosuke Morita
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka, Japan
| | - Yoshihiro Momota
- Department of Anesthesiology, Osaka Dental University, Osaka, Japan
| | - Yasuo M Tsutsumi
- Department of Anesthesiology, Tokushima University, Tokushima, Japan
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Toupin April K, Higgins J, Ehrmann Feldman D. Application of Rasch analysis to the parent adherence report questionnaire in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2016; 14:45. [PMID: 27465748 PMCID: PMC4964304 DOI: 10.1186/s12969-016-0105-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/19/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Adherence to treatment in children with juvenile idiopathic arthritis (JIA) is associated with better outcomes. Assessing patient adherence in JIA, as well as attitudes and beliefs about prescribed treatments, is important for the clinician in order to optimize patient management. The objective of the current study was to evaluate the psychometric properties of the Parent (proxy-report) Adherence Report Questionnaires (PARQ), which assesses beliefs and behaviors related to adherence to treatments prescribed for JIA. METHODS A Rasch analysis was conducted on data collected with parents of children with JIA from two studies in which the PARQ was used as a measure of adherence. RESULTS The PARQ showed preliminary evidence of multidimensionality with two factors, accounting for 38 % and 27 % of the variance respectively. The PARQ in its original version does not adhere to expectations of the Rasch model. A transformed version of the PARQ obtained by deletion of the general adherence scale and modification of visual analog scales into 5-point likert scales improved fit to the model and showed preliminary evidence of unidimensionality. CONCLUSIONS The PARQ was transformed based on the results of the Rasch analysis. The transformed version of the PARQ shows preliminary evidence of unidimensionality and may allow computation of a total score, although further testing is needed to verify these findings.
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Affiliation(s)
- Karine Toupin April
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, room R1132, Ottawa, Ontario, Canada. .,Department of Pediatrics, University of Ottawa, Ontario, Canada.
| | - Johanne Higgins
- École de Réadaptation, Université de Montréal, and researcher, Centre de recherche interdisciplinaire en réadaptation (CRIR) - Institut de Réadaptation Gingras-Lindsay-de Montréal du CIUSS-Centre-Sud de Montréal, Montreal, Canada
| | - Debbie Ehrmann Feldman
- École de Réadaptation and Institut de recherche en santé publique de l’Université de Montréal (IRSPUM), Université de Montréal, Centre de recherche interdisciplinaire en réadaptation (CRIR), Montreal, Canada
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Odole AC, Odunaiya NA, Mbaike CF, Ibikunle PO, Akinseloyin AA, Olaseinde OR. Nigerian (Yoruba) version of Disabilities of the Arm, Shoulder and Hand questionnaire (DASH-Y): Cross-cultural adaptation and initial validation. HAND THERAPY 2016. [DOI: 10.1177/1758998316656659] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a widely used upper extremity outcome measure. However, it is yet to be translated into any of the major languages in Nigeria, thus limiting its utility in the Nigerian clinical setting. The aim of this study was to cross-culturally adapt the DASH questionnaire into Yoruba, a major Nigerian language and investigate its initial validation. Methods The English version of DASH was adapted into Yoruba through forward–back translations, experts’ committee meetings, pretesting and cognitive debriefing interview in accordance with the guidelines recommended by the developers of DASH. Fifty-two purposively selected patients with upper extremity musculoskeletal disorders participated in a cross-sectional survey. Factor analysis was performed to ensure structural validity of Yoruba version, and construct validity was investigated with Spearman rank correlation coefficient. Results The Yoruba version of DASH has semantic, idiomatic, linguistic and conceptual equivalence with the English DASH. Thirty linear components were identified within the data set. Principal factor analysis of the Yoruba DASH revealed a seven factor scale, having fulfilled all the necessary conditions. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.61, and Barlett’s test of Sphericity was adequate and significant (χ2 (1066) = 435, p = 0.001). Significant correlation (r = 0.994, p = 0.001) exists between scores obtained on English and Yoruba versions of DASH. Conclusion A cross-culturally adapted, valid Yoruba version of DASH is available for use in in south western Nigeria and other similar populations.
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Affiliation(s)
- Adesola C Odole
- Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Nse A Odunaiya
- Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Chidinma F Mbaike
- Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Peter O Ibikunle
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikwe University, Awka, Nigeria
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Rodrigues J, Zhang W, Scammell B, Russell P, Chakrabarti I, Fullilove S, Davidson D, Davis T. Validity of the Disabilities of the Arm, Shoulder and Hand patient-reported outcome measure (DASH) and the Quickdash when used in Dupuytren's disease. J Hand Surg Eur Vol 2016; 41:589-99. [PMID: 26307142 DOI: 10.1177/1753193415601350] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 07/17/2015] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study investigated aspects of the validity and reliability of the 30-item Disabilities of the Arm, Shoulder and Hand patient-reported outcome measure (DASH) and its relationship with the shorter 11-item QuickDASH in patients with Dupuytren's disease.Seven hundred and fifty-nine DASH questionnaires were studied, covering pre- and postoperative patients undergoing different treatments for Dupuytren's disease. Items related to pain rose early after treatment before returning to baseline, suggesting that studying pain is relevant during postoperative recovery. Across all 759 sets of responses, the QuickDASH agreed closely with the DASH. In exploratory factor analysis, the DASH was not unidimensional, questioning the validity of the DASH summary score in Dupuytren's disease.Further validation of existing PROMs for use in Dupuytren's disease is needed. These data suggest that pain is a relevant symptom to study during postoperative recovery following treatment for Dupuytren's disease. LEVEL OF EVIDENCE III.
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Affiliation(s)
- J Rodrigues
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Nuffield Orthopaedic Centre, Oxford, UK
| | - W Zhang
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham & Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
| | - B Scammell
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham & Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
| | - P Russell
- Pulvertaft Hand Centre, Royal Derby Hospital, Uttoxeter New Road, Derby, UK
| | | | | | - D Davidson
- St John's Hospital at Howden, Livingston, UK
| | - T Davis
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham & Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
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Modified Great Toe Wraparound Flap with Preservation of Plantar Triangular Flap for Reconstruction of Degloving Injuries of the Thumb and Fingers. Plast Reconstr Surg 2016; 138:155-163. [DOI: 10.1097/prs.0000000000002301] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Prokopenko SV, Mozheyko EY, Alekseevich GV. Methods of assessment of movement functions in the upper limb. Zh Nevrol Psikhiatr Im S S Korsakova 2016. [DOI: 10.17116/jnevro201611671101-107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Rasch analysis of the Patient Rated Elbow Evaluation questionnaire. Health Qual Life Outcomes 2015; 13:84. [PMID: 26092294 PMCID: PMC4482053 DOI: 10.1186/s12955-015-0275-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 05/26/2015] [Indexed: 01/22/2023] Open
Abstract
Background The Patient Rated Elbow Evaluation (PREE) was developed as an elbow joint specific measure of pain and disability and validated with classical psychometric methods. More recently, Rasch analysis has contributed new methods for analyzing the clinical measurement properties of self-report outcome measures. The objective of the study was to determine aspects of validity of the PREE using the Rasch model to assess the overall fit of the PREE data, the response scaling, individual item fit, differential item functioning (DIF), local dependency, unidimensionality and person separation index (PSI). Methods A convenience sample of 236 patients (Age range 21–79 years; M: F- 97:139) with elbow disorders were recruited from the Roth│McFarlane Hand and Upper Limb Centre, London, Ontario, Canada. The baseline scores of the PREE were used. Rasch analysis was conducted using RUMM 2030 software on the 3 sub scales of the PREE separately. Results The 3 sub scales showed misfit initially with disordered thresholds on17 out of 20 items), uniform DIF was observed for two items (“Carrying a 10lbs object” from specific activities subscale for age group; and “household work” from the usual activities subscale for gender); multidimensionality and local dependency. The Pain subscale satisfied Rasch expectations when item 2 “Pain – At rest” was split for age group, while the usual activities subscale readily stood up to Rasch requirements when the item 2 “household work” was split for gender. The specific activities subscale demonstrated fit to the Rasch model when sub test analysis accounted for local dependency. All three subscales of the PREE were well targeted and had high reliability (PSI >0.80). Conclusion The three subscales of the PREE appear to be robust when tested against the Rasch model when subject to a few alterations. The value of changing the 0–10 format is questionable given its widespread use; further Rasch-based analysis of whether these findings are stable in other samples is warranted.
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