Validation of the MSK-HQ in a hand therapy setting

There is a shortage of clinical tools integrating the individual journey through healthcare, as care providers frequently use diverse Patient Reported Outcome Measures (PROMs) that cannot be easily aggregated. The use of a single PROM from primary care into tertiary care would enable a more cohesive journey. The MSK-HQ has the potential to be used in this way but requires validation within the hand therapy population. Our hypothesis is that the concurrent validity and responsiveness of the Musculoskeletal Health Questionnaire (MSK-HQ), is non-inferior to the QuickDASH.

382 individual outcome measures were reviewed spanning a period of 1 year from 07/2022 until 08/2023. Individual demographic information including; sex, age, ethnicity, chronicity, referral source, and borough were collected. Receiver operating characteristic (ROC) curves assessed the ability of the average 4-months change in both MSK-HQ and QuickDASH to distinguish between individuals who showed improvement and those who did not, based on global change scores, calculating MCID.

Spearman's correlation between the global change anchor and MSK-HQ was 0.53 (95% CI: 0.45-0.60), and between the global change anchor and QuickDASH was 0.55 (95% CI: 0.48-0.62). The MSK-HQ demonstrated a strong ability to discriminate between Hand Therapy individuals reporting global improvement versus no improvement, with an area under the curve (AUC) of 0.82 (95% CI: 0.77-0.86), comparable to the QuickDASH, which had an AUC of 0.83 (95% CI: 0.79-0.88). The interpretability of a significant improvement in the MSK-HQ was 4.5 points of change.

The analysis validated our hypothesis and revealed no statistically significant difference in sensitivity or improvement in reporting change scores, indicating that the MSK-HQ is non-inferior to the established benchmark, QuickDASH, and is therefore suitable for use in Hand Therapy.