Psychometric properties of patient-reported outcome measures assessing recovery from hand fractures: a systematic review.

ABSTRACT

PURPOSE: To extensively review Patient Reported Outcome Measures (PROMs) used to assess outcomes in persons with hand fractures in terms of their psychometric properties. METHODS: A COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodological review was conducted. Six electronic databases were searched (Medline, Embase, Scopus, Web of Science, PsycINFO, CINAHL) for studies evaluating the psychometric properties of PROMs assessing recovery from hand fracture. Titles and abstracts, full text review, quality assessment and data extraction were performed by two reviewers. Any disagreements were resolved after review by a third, expert reviewer. Quality assessment of included studies was performed using the COSMIN checklist. RESULTS: This COSMIN review found that there were only 4 studies that fulfilled the inclusion criteria in terms of assessing measurement properties of PROMs in hand fractures. Only the construct validity of the Disabilities of the Arm, Shoulder, and Hand (DASH), the Quick DASH (QDASH) and the Duruoz Hand Index (DHI), and the responsiveness of the DASH, the Patient Specific Functional Scale (PSFS), the Patient-Rated Wrist and Hand Evaluation (PRWHE) and the Michigan Hand Outcomes Questionnaire (MHQ) were assessed in these studies. The overall rating of the studies was assessed as insufficient or indeterminate and quality of evidence was assessed as moderate, low, or very low by our team. CONCLUSIONS: This study identified that there is a lack of evidence in the medical literature with regards to the measurement properties of PROMs in patients with hand fractures. The 4 included studies do not provide good quality data to support the use of these PROMS in patients with hand fractures. There is a need for more studies for more PROMs. This has important consequences for how outcomes will be measured in clinical studies in hand research and in clinical practice.

Hand fractures are some of the most common types of fractures in adults. They affect patients in the short term with everyday activities and can have a long-term impact especially on people who use their hands a lot at work and at home. The recovery from a hand fracture, with whatever treatment, can be captured by questionnaires completed by patients at frequent time intervals. We looked at whether questionnaires, which could do so for these patients, have been assessed in previous studies. Even though this is an important topic, we only found a handful of studies which have done so, and these were not very robust in their assessment. This study indicates that there needs to be more work in the field which will be very helpful for clinical practice and future research.