The reliability of remembered pre-operative patient-rated wrist and hand evaluation (PRWHE) scores

In clinical audits where pre-operative patient-rated wrist and hand evaluation (PRWHE) scores were not recorded, it would be useful if such scores could be recreated at the time of review. We recorded a PRWHE score during the last week before surgery for 143 patients. They were contacted after 21 months and asked to furnish a new PRWHE of the state they were in during the last week before surgery. 80 (56%) of the patients responded. The mean difference was 10 (SD: 20; SEM: 2) higher remembered pre-operative score. The limits of 95% agreement for individual scores were -29 and 50, while the 95% confidence interval of the mean was 6-15. If 10 is subtracted from the mean remembered preoperative score of a group of patients, the real pre-operative score will with 95% confidence be this score plus/minus 4. Remembered pre-operative PRWHE scores are far too inaccurate to be of value in individual patients. It may be possible to predict the mean real pre-operative PRWHE score in groups of patients with useful accuracy using the remembered pre-operative score.