The HAND-Q : Psychometrics of a New Patient-reported Outcome Measure for Clinical and Research Applications

Background: The perspective of the patient in measuring the outcome of their hand treatment is of key importance. We developed a hand-specific patient-reported outcome measure to provide a means to measure outcomes and experiences of care from the patient perspective, that is, HAND-Q. Methods: Data were collected from people with a broad range of hand conditions in hand clinics in six countries between April 2018 and January 2021. Rasch measurement theory analysis was used to perform item reduction and to examine reliability and validity of each HAND-Q scale. Results: A sample of 1277 patients was recruited. Participants ranged in age from 16 to 89 years, 54% were women, and a broad range of congenital and acquired hand conditions were represented. Rasch measurement theory analysis led to the refinement of 14 independently functioning scales that measure hand appearance, health-related quality of life, experience of care, and treatment outcome. Each scale evidenced reliability and validity. Examination of differential item functioning by age, gender, language, and type of hand condition (ie, nontraumatic versus traumatic) confirmed that a common scoring algorithm for each scale could be implemented. Conclusions: The HAND-Q was developed following robust psychometric methods to provide a comprehensive modular independently functioning set of scales. HAND-Q scales can be used to assess and compare evidence-based outcomes in patients with any type of hand condition.Peer reviewe

Assessment of construct validity of the Finnish versions of the Disabilities of Arm, Shoulder and Hand Instrument and the Michigan Hand Outcomes Questionnaire

Study Design: Cross-sectional study. Introduction: There is a lack of information on the measurement properties of patient-reported upperextremity 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 andconstruct validity of the Disabilities of Arm, Shoulder, and Hand (DASH) Instrument and the MichiganHand Questionnaire (MHQ) using a heterogeneous sample of patients with hand and wrist problems. Methods: Two hundredfifty consecutive patients visiting a general orthopedic outpatient clinic due tovarious hand/wrist problems were invited to participate in the study. A total of 193 (77%) participantsprovided sufficient patient-reported outcome data and were included in the analysis. Participantscompleted the DASH, the MHQ, the EQ-5D-3L, and pain on a visual analog scale instruments. Grip andkey pinch forces were measured. Scale targeting, relatedness of demographics, and construct validity ofthe DASH and the MHQ were assessed. Results: Both the DASH and the MHQ had good targeting, but the DASH had wider coverage. Theconvergence between the DASH and the MHQ was high. The DASH was more closely related to HRQoLthan the MHQ in terms of EQ-5D scores. Discussion: The DASH instrument appeared to measure hand function and disability from a perspective ofHRQoL 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 MHQmight be more specific for the affected hand.peerReviewe