[A simple orthopaedic patient questionnaire to measure symptoms and disabilities--validation and experience]

The aim of this study was to measure musculoskeletal symptoms and disabilities in a structured and objective manner. For this purpose, we have developed a simple patient questionnaire (Pationnaire). This includes the most important symptoms and signs of the entire musculoskeletal system including the vertebrae.

The questionnaire was tested for construct validity and reliability. The experiences were gathered in separate centres within an outcome study after total hip arthroplasty and routine consultations.

Construct validity was tested in 71 patients by comparing the questionnaire answers with details given by personal interview. Concordance was total in 95 %, partial in 3 %, and inadequate in 2 % (older patients with poly-morbidity). Concordance was improved by discussion, completion and correction of questionnaire answers together with the patient. Participants required an average of 9.9 minutes to complete the questionnaire. The test-retest reliability of the Pationnaire yielded, compared to the SF-36, more questions with a higher intraclass correlation coefficient (ICC); the mean ICC for all Pationnaire questions was 0.76 versus 0.57 for the SF-36. The percentage of identical answers was between 69.7 % and 99.4 % with the Pationnaire and between 52.2 % and 96.8 % with SF-36. User experience showed that the questionnaire can be used for initial and differential diagnosis, for improved communication with the patient, and to measure outcome. The questionnaire proved valuable in the differential diagnosis of symptoms after endoprosthesis. Information on type and location are particularly valuable in differentiating mechanical, inflammatory or other causes. The questionnaire can be used for outcome measurements in endoprosthesis. In 66 patients, 6 months after total hip prosthesis, pain scores were reduced from 47.8 to 29.5, symptom scores from 30.8 to 11.6, and disability scores from 22.5 to 10.5 (all changes statistically significant, p < 0.05).

The questionnaire reliably measures symptoms and disabilities in orthopaedic disease. Interactive collection of patient history renders it more objective. The questionnaire can be used in outpatient consultations, for initial and differential diagnosis, to improve communication, and to measure outcome.