Comprehensive Hand Evaluation Form: Feasibility of Merging the Most Common Hand-Specific Patient-Reported Outcome...

Area of Science:

• Orthopedics
• Hand Surgery
• Patient-Reported Outcome Measures

Background:

• Patient-reported outcome measures (PROMs) are crucial in hand surgery but their variety increases patient burden.
• Commonly used PROMs include the Disabilities of the Arm, Shoulder and Hand (DASH), Michigan Hand Outcomes Questionnaire (MHQ), and Patient-Rated Wrist/Hand Evaluation (PRWHE).
• Overlapping content among PROMs complicates selection and patient experience.

Purpose of the Study:

• To develop a merged instrument, the Comprehensive Hand Evaluation Form (CHEF).
• To assess the score equivalence between CHEF-derived scores and original DASH, MHQ, and PRWHE questionnaires.
• To evaluate the equivalence of pain ratings between numeric rating scale (NRS) and visual analogue scale (VAS).

Main Methods:

• Prospective study involving adults with chronic hand/wrist conditions.
• Patients completed CHEF in clinic, followed by original DASH-G, MHQ-G, and PRWHE-G via mail three days later.
• Equivalence testing used two one-sided tests with margins set at half the minimal clinically important difference; completion times were recorded.

Main Results:

• Equivalence was demonstrated between CHEF-derived and original PRWHE-G scores.
• Equivalence was not demonstrated for DASH-G or MHQ-G.
• CHEF completion time (median 10 min) was significantly shorter than combined original questionnaires (median 15 min).
• Pain rating equivalence between NRS and VAS was observed at rest, but not during activity.

Conclusions:

• The CHEF successfully reduced completion time for hand surgery outcome assessment.
• Score equivalence was achieved only for the PRWHE, indicating limitations in merging other PROMs.
• Integrated PROM approaches can reduce patient burden but may not consistently maintain score equivalence across all instruments.