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Development and validation of the patient-rated ulnar nerve evaluation
1Hand and Upper Limb Centre, 268 Grosvenor St, London, Ontario N6A 3A8, Canada. jmacderm@uwo.ca
BMC Musculoskeletal Disorders
|April 27, 2013
Summary
A new patient-reported outcome measure, the Patient-Rated Ulnar Nerve Evaluation (PRUNE), effectively assesses pain and functional disability in elbow ulnar nerve compression. This brief, open-access tool shows strong measurement properties for clinical research.
Area of Science:
- Orthopedics and Sports Medicine
- Neurology
- Rehabilitation Science
Background:
- Elbow compression neuropathy causes significant pain and disability.
- Lack of a specific outcome measure hinders clinical research for this condition.
- The Patient-Rated Ulnar Nerve Evaluation (PRUNE) was developed as a patient-reported outcome measure.
Purpose of the Study:
- To develop and validate the Patient-Rated Ulnar Nerve Evaluation (PRUNE) for assessing pain, symptoms, and functional disability in patients with ulnar nerve compression at the elbow.
- To establish the content validity, reliability, construct validity, and responsiveness of the PRUNE.
Main Methods:
- Iterative item development and testing, including patient/expert interviews and cognitive coding.
- Content validity linked to International Classification of Functioning, Disability, and Health (ICF) codes.
- Psychometric analysis of data from 89 patients, including item reduction, reliability testing, factor analysis, and validity assessments.
Main Results:
- Factor analysis revealed four subscales: pain, sensory/motor impairments, specific activity limitations, and usual activity/role restrictions.
- The PRUNE demonstrated high reliability (ICC > 0.90, total score 0.98) and excellent responsiveness (SRM = 1.55).
- The measure effectively discriminated between clinically meaningful subgroups (p < 0.01).
Conclusions:
- The PRUNE is a brief, open-access patient-reported outcome measure.
- It exhibits strong measurement properties for evaluating ulnar nerve compression at the elbow.
- PRUNE is suitable for assessing outcomes in clinical research and practice.
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