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Determining the minimal clinically important difference of the hand function sort questionnaire in vocational rehabilitation - 30/05/19

Doi : 10.1016/j.rehab.2018.11.003 
Zineb Benhissen a, Michel Konzelmann a, , Philippe Vuistiner c, Bertrand Léger c, François Luthi a, c, d, Charles Benaim b, c
a Department of musculoskeletal rehabilitation, Clinique Romande de Réadaptation SuvaCare, 90, avenue Grand-Champsec, 1951 Sion, Switzerland 
b Division of Physical Medicine and Rehabilitation, Orthopaedic Hospital, Lausanne University Hospital, avenue Pierre Decker 4, CH-1011 Lausanne, Switzerland 
c Institute for Research in Rehabilitation, Clinique Romande de Réadaptation Suvacare, 90, avenue Grand-Champsec, 1950 Sion, Switzerland 
d Orthopaedic Hospital, Lausanne University Hospital, 21, rue du Bugnon, 1011 Lausanne, Switzerland 

Corresponding author.

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Highlights

The Minimal Clinically Important Difference (MCID) allows for measuring the improvement of patients.
The MCID can be used to better manage treatment.
Knowing the MCID of the Hand Function Sort questionnaire (HFS) can improve communication between therapists.
In vocational rehabilitation, the HFS is used to predict the ability to resume work.

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Abstract

Objective

To estimate the Minimal Clinically Important Difference (MCID) of the French version of the Hand Function Sort questionnaire (HFS-F). As a comparison, the MCID of the Disabilities of the Arm, Shoulder, and Hand (DASH) was also estimated.

Materials and methods

We included French-speaking patients hospitalized in a multidisciplinary rehabilitation program for chronic pain of the upper limb after an accident. HFS-F and DASH scores were collected at admission and discharge; the Patient Global Impression of Change measure (PGIC; 7 levels) was collected at discharge. The MCID was estimated by 2 methods: the anchor-based method (receiver operating characteristic [ROC], delta (Δ) mean of scores) and the objective method based on the distribution of scores (standard error of measurement, SEM).

Result

We included 225 patients. By the anchor-based method, the MCID for the HFS-F and DASH was +26 (SD 35) (P<10−4) and −13 (SD 13) (P<10−4), respectively, and by the ROC curve, it was +10 to +12 for the Δ-HFS-F and −7.5 to −5 for the Δ-DASH. The area under the ROC curve (AUC) was 0.726 [0.638–0.781] for Δ-HFS-F and 0.768 [0.701–0.83] for Δ-DASH. The correlations between the anchor and delta scores were>0.38 (P<10−4). The SEM was 16.2 for the HFS-F and −4.3 for the DASH.

Conclusions

Values below the SEM must be rejected. Our anchor was significantly correlated with the outcome. Therefore, we propose an MCID for the HFS-F of 26, corresponding to approximately 10% progression of the score.

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Keywords : Treatment outcome, Surveys and questionnaires, Upper extremity, Recovery of function, Rehabilitation


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© 2018  The Author(s). Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 62 - N° 3

P. 155-160 - maggio 2019 Ritorno al numero
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