Site-specific Patient-reported Outcome Measures for Hand Conditions: Systematic Review of Development and Psychometric Properties

BACKGROUND: There are a number of site-specific patient-reported outcome measures (PROMs) for hand conditions used in clinical practice and research for assessing the efficacy of surgical and nonsurgical interventions. The most commonly used hand-relevant PROMs are as follows: Disabilities of the Arm, Shoulder and Hand (DASH), QuickDASH (qDASH), Michigan Hand Questionnaire (MHQ), Patient Evaluation Measure (PEM), Upper Extremity Functional Index (UEFI), and Duruoz Hand Index (DHI). There has been no systematic evaluation of the published psychometric properties of these PROMs. METHODS: A PRISMA-compliant systematic review of the development and validation studies of these hand PROMs was prospectively registered in PROSPERO and conducted to assess their psychometric properties. A search strategy was applied to Medline, Embase, PsycINFO, and CINAHL. Abstract screening was performed in duplicate. Assessment of psychometric properties was performed. RESULTS: The search retrieved 943 articles, of which 54 articles met predefined inclusion criteria. There were 19 studies evaluating DASH, 8 studies evaluating qDASH, 13 studies evaluating MHQ, 5 studies evaluating UEFI, 4 studies evaluating PEM, and 5 studies evaluating DHI. Assessment of content validity, internal consistency, construct validity, reproducibility, responsiveness, floor/ceiling effect, and interpretability for each PROM is described. CONCLUSIONS: The psychometric properties of the most commonly used PROMs in hand research are not adequately described in the published literature. DASH, qDASH, and MHQ have the best-published psychometric properties, though they have either some poor psychometric performance or incompletely studied psychometric properties. There are more limited published data describing the psychometric properties of the UEFI, PEM, and DHI.