Highlights
- •Concurrent validity of the bMHQ and TDX was high and statistically significant.
- •The TDX test-retest reliability via intraclass correlation coefficient was excellent.
- •The TDX can reliably find a difference in two scores when it is more than 6 points.
- •The TDX shows a clinically meaningful change in scores when it is more than 17 points.
Abstract
Study Design
A descriptive psychometric study of precision and concurrent validity of the Thumb
Disability Examination (TDX).
Introduction
Thumb carpometacarpal osteoarthritis (CMC OA) is a painful joint condition impacting
the functionality of the hand. Therapists use patient-reported outcome measures to
evaluate change in disability and symptomology in response to interventions. The TDX
is the only condition-specific outcome measure for persons with thumb CMC OA. Its
responsiveness, test-retest reliability and concurrent validity with the DASH are
published, yet it's precision and concurrent validity with a hand-region-specific
tool has not yet been established.
Purpose of the Study
We aimed to determine the precision and concurrent validity of the TDX with a region-specific
outcome measure in people with thumb CMC OA.
Methods
Sixteen individuals with a medical diagnosis of CMC OA or a positive pressure-shear
test completed the TDX across two visits and the Brief Michigan Hand Questionnaire
(bMHQ) at the initial visit. The second visit was 7 to 21 days after the first. Self-administration
of the TDX and bMHQ were observed by a licensed occupational therapist.
Results
Across total and subscale scores of the TDX, standard error of measurement (SEM) values
are used to indicate the precision of tool and demonstrate how confident a user can
be that change in score exceeds the error inherent to the tool. Minimal detectable
change percentage (MDC%) values for the TDX are acceptable (<30%). The TDX demonstrated
high concurrent validity with the bMHQ (rs = -0.733; P = .001).
Discussion
Precision of the TDX is acceptable and the concurrent validity of the TDX with a commonly
used region-specific scale is high. The study was limited by a small, demographically
homogeneous sample due to difficulty in recruitment.
Conclusions
The TDX is a precise and valid outcome measure for individuals having a clinical diagnosis
or indications of having thumb CMC OA.
Keywords
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JHT Read for Credit
Quiz: # 862
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.The term “region specific” refers to
- a.the upper midwestern USA
- b.the SE section of Minneapolis
- c.an anatomic region, in this case the thumb CMC
- d.an anatomic region, in this case the hand
- a.
- # 2.To evaluate whether the score exceeded the inherent error in the tool, ________values were used
- a.SEM
- b.ANOVA
- c.ICC
- d.ACC
- a.
- # 3.Subjects were included if they
- a.were referred by their employer
- b.had a positive X-ray
- c.scored poorly on the DASH
- d.had a positive shear test
- a.
- # 4.The TDX is
- a.a generalized outcome measure similar to the DASH
- b.untested for its validity prior to this study
- c.disease specific
- d.universally used in hand therapy clinics, both in the US & UK
- a.
- # 5.The limited sample size makes broad conclusions problematic
- a.false
- b.true
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: September 23, 2021
Accepted:
July 4,
2021
Received in revised form:
June 28,
2021
Received:
February 17,
2021
Footnotes
Conflict of interest: The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
