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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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