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The Patient Perspective on Patient-Reported Outcome Measures Following Elective Hand Surgery: A Convergent
Lauren M Shapiro1, Sara L Eppler1, Allison K Roe1
1Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
The Journal of Hand Surgery
|November 13, 2020
Summary
Patient-Specific Functional Scale (PSFS) is preferred over QuickDASH for hand surgery outcomes. PSFS offers personalized assessment and better measures patient goals, improving quality of care evaluation.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Health Outcomes Research
Background:
- Patient-reported outcome measures (PROMs) are increasingly used beyond research to assess patient perspectives and guide care.
- Evaluating the utility and patient preference of different PROMs is crucial for effective clinical application.
Purpose of the Study:
- To compare the Patient-Specific Functional Scale (PSFS) and the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) in elective hand surgery patients.
- To assess patient preference, goal measurement, and treatment responsiveness of these two PROMs.
Main Methods:
- A mixed-methods approach combining quantitative and qualitative analyses was employed.
- Patients undergoing elective hand surgery completed QuickDASH and PSFS questionnaires pre- and post-operatively, along with preference questions.
- Responsiveness was measured by score changes, and qualitative analysis identified themes in PROM preferences.
Main Results:
- The Patient-Specific Functional Scale (PSFS) was preferred by 77% of patients over the QuickDASH.
- PSFS demonstrated greater responsiveness to treatment, with 68% of patients exceeding the minimal clinically important difference (MCID) compared to 40% for QuickDASH.
- Key preference themes included instrument simplicity, personalized assessment, goal-directedness, and distinct items.
Conclusions:
- The PSFS is a preferred PROM for hand surgery patients due to its simplicity, personalization, and focus on patient-specific goals.
- While standardized PROMs offer broad comparisons, patient-specific PROMs like PSFS better capture individual care priorities.
- Combining standardized and patient-specific PROMs can provide comprehensive outcome assessment and inform quality improvement initiatives.
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