Highlights
- •There are many patient reported outcome measures for a variety of upper extremity disorders, but it's not always clear which measure is most useful clinically or academically.
- •Clinical decisions around which tool will depend on which psychometric property is most important for the assessment and whether global or specific condition assessment is needed.
Abstract
Background
Multiple options for patient reported outcome measures are available to assess patients
with hand, wrist and elbow impairments. This review of systematic reviews (overview)
evaluated the evidence on these outcome measures.
Methods
An electronic search of six databases (MEDLINE, Embase, CINAHL, ILC, the Cochrane
Central Register of Controlled Trials (CENTRAL), and LILACS) was performed in September
2019, and updated in August 2022. The search strategy was designed to locate systematic
reviews that addressed at least one clinical measurement property of PROMs used for
patients with hand and wrist impairment. Two independent reviewers screened the articles
and extracted the data. The AMSTAR tool was used to assess the risk of bias in the
included articles.
Results
Eleven systematic reviews were included in this overview. A total of 27 outcome assessments
were assessed, with DASH, PRWE and MHQ assessed by five, four, and three reviews,
respectively. We found high-quality evidence of good to excellent internal consistency
(ICC = 0.88-0.97), poor content validity but high construct validity (r > 0.70), moderate-
to high-quality evidence for the DASH. The reliability of the PRWE was excellent (ICC
>0.80), the convergent validity was excellent (r > 0.75), but poor criterion validity
compared to the SF-12. The MHQ also reported excellent reliability (ICC = 0.88-0.96),
and good criterion validity (r > 0.70), but poor construct validity (r > 0.38).
Conclusion
Clinical decisions around which tool will depend on which psychometric property is
most important for the assessment and whether global or specific condition assessment
is needed. All of the tools demonstrated at least good reliability; therefore, the
clinical decisions will rely on the type of validity for clinical application. The
DASH has good construct validity, while the PRWE has good convergent validity, and
the MHQ has good criterion validity.
Keywords
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Article info
Publication history
Published online: March 11, 2023
Accepted:
October 14,
2022
Received in revised form:
May 19,
2022
Received:
March 31,
2021
Publication stage
In Press Corrected ProofFootnotes
Conflict of interest: All named authors hereby declare that they have no conflicts of interest to disclose.
Identification
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