The Single Assessment Numerical Evaluation (SANE) published by Gire et al. and the Self-Perceived Hand Normality published by Stirling et al. are existing global assessments of hand function that correlates with the QuickDASH score, and which are thus useful to quantify the improvements observed after surgery. However, they do not provide a significant assistance to surgeons in the decision-making process. Therefore, a simple 2-step method, the Overall Subjective Self-Assessment (OSSA), is daily used in our hand department for each patient to assess their complaints.

The OSSA is a brief and interactive method that enables to quantify and rank the patient's complaints according to what they believe impairs them. It is a self-assessment (subjective) that tailors the evaluation to the patient's perspective, hence, it can be used as patient reported outcomes (PROMs) to obtain a more comprehensive understanding of the patient complaints, as reported by Rob et al. The OSSA is used at the beginning of the consultation, whether it is the initial visit or the last follow-up. The first part of this 2-step method provides an overview of the patient's overall disability, while the second part allows clarifying the patient's complaints, guiding the surgeon to determine the most appropriate aim to achieve. The evaluation starts by an overall assessment of the hand function, ranging from 0 to 10 points, which is similar to the SANE [1]. This subjective evaluation is performed by asking the patient: “How much do you rate your hand considering that 10 is a normal hand?”. Then, the patient is asked to rate the loss and to assign the reasons for not obtaining a full score. There are two main categories to assign the specific causes: function (pain, mobility, strength, sensibility) and aesthetics.

The OSSA is particularly valuable for complex cases or when multiple hand disorders are observed. Moreover, this approach empowers and invites the patients to be involved in the decision-making process. The most impairing issue perceived by the surgeons are not always the patient's primary concern. The doctor–patient relationship evolved over the years from a paternalistic one to an egalitarian one. Consequently, subjective symptoms and the patient's opinion have a more prominent role in the treatment strategy, especially in the field of hand surgery, a care that do not save live but improve the quality of life.

The OSSA is a simple method that aligns with modern medical practice.