Correlation of the I-HaND Scale with Other Musculoskeletal Patient-Reported Outcome Measurement Scores

Abstract

Background Experiments can determine if nerve-specific patient-reported outcome measures (PROMs) can outperform regional or condition-specific PROMs. We compared a nerve-specific PROM of the upper extremity, the Impact of Hand Nerve Disorders (I-HaND) scale, to other validated measures quantifying activity intolerance and sought to assess interquestionnaire correlations and factors independently associated with activity intolerance and pain intensity.

Methods One hundred and thirty patients with any upper extremity nerve-related condition completed measures of demographics, psychological limitations, quality of life, activity intolerance, and pain intensity. To quantify activity intolerance, we used the I-HaND, Patient-Reported Outcomes Measurement Information System Physical Function Upper Extremity, and Disabilities of the Arm, Shoulder and Hand short form.

Results Strong interquestionnaire correlations were found between the activity intolerance measures (r between 0.70 and 0.91). Multivariable analysis revealed that greater activity intolerance and greater pain intensity correlated most with greater symptoms of depression on all scales, with symptoms of depression accounting for 53 to 84% of the variability in the PROMs.

Conclusion There is no clear advantage of the nerve-specific I-HaND over shorter, regional PROMs, perhaps because they are all so closely tied to mental health. Unless an advantage relating to responsiveness to treatment is demonstrated, we support using a brief arm-specific PROM for all upper extremity conditions.

Level of Evidence Level II; Prognostic.

Keywords

PROMs - nerve compression - nerve trauma - I-HaND - PROMIS PF-UE - QuickDASH - pain intensity

Ethical Committee Approval

This study received approval from the Institutional Review Board of the University of Texas at Austin. This study has been performed in accordance with the ethical standards in the 1964 Declaration of Helsinki. This study has been performed in accordance with relevant regulations of the U.S. Health Insurance Portability and Accountability Act (HIPAA).

Statement of Location

This study was performed at The Dell Medical School – The University of Texas.

Publication History

Article published online:
25 August 2021

• References

• 1 Chung KC, Pillsbury MS, Walters MR, Hayward RA. Reliability and validity testing of the Michigan Hand Outcomes Questionnaire. J Hand Surg Am 1998; 23 (04) 575-587
• 2 Beaton DE, Wright JG, Katz JN. et al. Development of the QuickDASH: comparison of three item-reduction approaches J Bone Jt Surg - Ser A. 2005; 5: 1038-1046
• 3 Hudak PL, Amadio PC, Bombardier C. The Upper Extremity Collaborative Group (UECG). Development of an upper extremity outcome measure: the DASH (Disabilities of the Arm, Shoulder and Hand) [corrected]. Am J Ind Med 1996; 29 (06) 602-608
• 4 Kaat AJ, Buckenmaier III CT, Cook KF. et al. The expansion and validation of a new upper extremity item bank for the Patient-Reported Outcomes Measurement Information System® (PROMIS. J Patient Rep Outcomes 2019; 3 (01) 69
• 5 Levine DW, Simmons BP, Koris MJ. et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Jt Surg - Ser A 1993; 11: 1585-1592
• 6 Ashwood M, Jerosch-Herold C, Shepstone L. Development and validation of a new patient-reported outcome measure for peripheral nerve disorders of the hand, the I-HaND© Scale. J Hand Surg Eur Vol 2018; 43 (08) 864-874
• 7 Bot AGJ, Nota SPFT, Ring D. The creation of an abbreviated version of the PSEQ: the PSEQ-2. Psychosomatics 2014; 55 (04) 381-385
• 8 Archer KR, Phelps KD, Seebach CL. Song Y, Riley LH III, Wegener ST. Comparative study of short forms of the Tampa Scale for Kinesiophobia: fear of movement in a surgical spine population. Arch Phys Med Rehabil 2012; 93 (08) 1460-1462
• 9 Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care 2003; 41 (11) 1284-1292
• 10 Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16 (09) 606-613
• 11 EuroQol Group. EuroQol–a new facility for the measurement of health-related quality of life. Health Policy 1990; 16 (03) 199-208
• 12 Euroqol. EQ-5D User Guides – EQ-5D. Published December 2018. Available at: https://euroqol.org/publications/user-guides/. Accessed July 9, 2020
• 13 Ramos-Goni JM, Rivero-Arias O. Eq5d: a command to calculate index values for the EQ-5D quality-of-life instrument. Stata J 2011; 11 (01) 120-125
• 14 Shaw JW, Johnson JA, Coons SJ. US valuation of the EQ-5D health states: development and testing of the D1 valuation model. Med Care 2005; 43 (03) 203-220
• 15 PROMIS. PROMIS PF Scoring. Available at: http://www.healthmeasures.net/administrator/components/com_instruments/uploads/PROMIS Physical Function Scoring Manual.pdf. Accessed July 27, 2021
• 16 Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg 2018; 126 (05) 1763-1768
• 17 Jansen MC, Evers S, Slijper HP. et al. Predicting clinical outcome after surgical treatment in patients with carpal tunnel syndrome. J Hand Surg Am 2018; 43 (12) 1098-1106.e1
• 18 Lozano Calderón SA, Paiva A, Ring D. Patient satisfaction after open carpal tunnel release correlates with depression. J Hand Surg Am 2008; 33 (03) 303-307
• 19 Kazmers NH, Hung M, Rane AA, Bounsanga J, Weng C, Tyser AR. Association of physical function, anxiety, and pain interference in nonshoulder upper extremity patients using the PROMIS platform. J Hand Surg Am 2017; 42 (10) 781-787
• 20 Jayakumar P, Overbeek CL, Lamb S. et al. What factors are associated with disability after upper extremity injuries? A systematic review. Clin Orthop Relat Res 2018; 476 (11) 2190-2215