Measurement properties of the Dutch Unite Rhumatologique des Affections de la Main and its ability to measure change due to Dupuytren's disease progression compared with the Michigan Hand outcomes Questionnaire.
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SUBMITTER: Broekstra DC
PROVIDER: S-EPMC6139982 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The purpose of this study was to determine and compare the responsiveness of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Michigan Hand Questionnaire (MHQ), and the Patient-Specific Functional Scale (PSFS) in patients with carpal tunnel syndrome, wrist pain, finger contracture, or tumor. Eighty-one subjects prospectively completed each questionnaire shortly before and 3 and 6 months after surgery. Data were analyzed using one-way analysis of variance and Newman-Keuls multiple comparison tests. Responsiveness to clinical change was calculated using standardized response means. The DASH was responsive for those with carpal tunnel syndrome (0.77), wrist pain (0.61), and tumor (0.55); the MHQ was responsive for those with carpal tunnel syndrome (1.04), wrist pain (0.87), and finger contracture (0.62); and the PSFS was responsive for those with carpal tunnel syndrome (0.65) and finger contracture (0.64). The interval during which the highest responsiveness occurred for the carpal tunnel, wrist pain, and finger contracture groups was the preoperative to 6-month period. The tumor group experienced the highest responsiveness during the preoperative to 3-month period. Our results indicate that one or more of the instruments evaluated are suitable for outcomes research related to surgery to treat carpal tunnel syndrome, wrist pain, finger contracture, and tumor.
| S-EPMC2724618 | biostudies-other
Project description:The Michigan Hand Outcomes Questionnaire has been widely used for nearly 20 years to assess patients with a variety of hand and upper extremity conditions. However, normative data have not previously been collected, limiting interpretation.The Michigan Hand Outcomes Questionnaire was administered to 579 participants recruited from the general population. In addition, participants were asked to identify any problem affecting their hand(s), including trauma, hand disease/condition, systemic illness, or nonspecific symptoms. Comorbidities and demographic data were also collected.Total Michigan Hand Outcomes Questionnaire score for healthy individuals was indicative of generally good hand function (95.2; 95 percent CI, 94.3 to 96.1). Individuals with unilateral trauma scored for their affected hand (90.3; 95 percent CI, 87.9 to 92.6) lower than their healthy hand (mean difference, 5.7; 95 percent CI, 3.2 to 8.3). For individuals with and without hand trauma, total Michigan Hand Outcomes Questionnaire score decreased with increasing number of comorbidities. Many of the differences in Michigan Hand Outcomes Questionnaire score between the problem hand and unaffected hand were smaller than the minimal clinically important difference of 3.0 to 23.0 for known abnormalities of the hand and upper extremity.These normative data provide appropriate baseline information for individuals with and without underlying hand conditions. Most notably, these findings suggest that individuals with a unilateral problem establish new subnormative values for both their affected and unaffected hands. These data will encourage an appropriate understanding of the results of future studies using the Michigan Hand Outcomes Questionnaire.
| S-EPMC5588690 | biostudies-literature
Project description:IntroductionThe Michigan Hand Outcomes Questionnaire (MHQ) is a patient-reported outcome measure previously validated in patients with rheumatoid arthritis (RA) using classical test theory. Rasch analysis is a more rigorous method of questionnaire validation that has not been used to test the psychometric properties of the MHQ in patients with RA. The objective of this study is to evaluate the validity and reliability of the MHQ for measuring outcomes in patients with RA with metacarpophalangeal joint deformities.MethodsWe performed a Rasch analysis using baseline data from the Silicone Arthroplasty in Rheumatoid Arthritis (SARA) prospective cohort study. All domains were tested for threshold ordering, item fit, targeting, differential-item functioning, unidimensionality, and internal consistency.ResultsThe Function and Work domains showed excellent fit to the Rasch model. After making adjustments, the Pain, Activities of Daily Living (ADL) and Satisfaction domains also fulfilled all Rasch model criteria. The Aesthetics domain met the majority of Rasch criteria, but could not be tested for unidimensionality.ConclusionsAfter collapsing disordered thresholds and removing misfitting items, the MHQ demonstrated reliability and validity for assessing outcomes in patients with RA with metacarpophalangeal joint deformities. These results suggest that interpreting individual domain scores may provide more insight into a patient's condition rather than analyzing an overall MHQ summary score. However, more Rasch analyses are needed in other RA populations before making adjustments to the MHQ.
| S-EPMC8297815 | biostudies-literature
Project description:Background Research evaluating mediated physical activity campaigns uses an unsophisticated conceptualization of the media and would benefit from the application of a media studies approach. The purpose of this article is to report on the application of this type of analysis to the Canada on the Move media campaign. Methods Through interviews and document analysis, the press release surrounding Canada on the Move was examined at four levels: inception, production, transmission and reception. Analytic strategies of thematic and textual analysis were conducted. Results and Conclusion The press release was well received by journalists and editors and was successfully transmitted as inferred from national and local television coverage, although there was no national print pickup. Canada on the Move was perceived by sampled audience members as a useful and interesting strategy to encourage walking. A holistic approach to media analysis reveals the complex and frequently messy process of this mediated communication process. Implications for future media disseminations of Canada on the Move are discussed. Electronic Supplementary Material Supplementary material is available for this article at 10.1007/BF03405360 and is accessible for authorized users.
| S-EPMC6976043 | biostudies-literature
Project description:Valid and reliable measurement of an individual's knowledge and risk perception is pivotal to monitor and evaluate the effectiveness of interventions aimed at preventing cardiovascular diseases (CVDs). The recently developed Attitudes and Beliefs about Cardiovascular Disease (ABCD) knowledge and risk questionnaire is shown to be valid in England. In this study, we evaluated the psychometric properties of the modified and Dutch (Flemish)-translated ABCD questionnaire using both the classical test and item response theory (IRT) analysis. We conducted a community-based survey among 525 adults in Antwerp city, Belgium. We assessed the item- and scale-level psychometric properties and validity indices of the questionnaire. Parameters of IRT, item scalability, monotonicity, item difficulty and discrimination, and item fit statistics were evaluated. Furthermore, exploratory and confirmatory factorial validity, and internal consistency measures were explored. Descriptive statistics showed that both the knowledge and risk scale items have sufficient variation to differentiate individuals' level of knowledge and risk perception. The overall homogeneity of the knowledge and risk subscales was within the acceptable range (> 0.3). The exploratory and confirmatory factor analyses of the risk scale supported a three-factor solution corresponding to risk perception (F1), perceived benefits and intention to change physical activity (F2), and perceived benefit and intention to change healthy dietary habit (F3). The two parametric logistic (2-PL) and rating scale models showed that the item infit and outfit values for knowledge and risk subscales were within the acceptable range (0.6 to 1.4) for most of the items. In conclusion, this study investigated the Dutch (Flemish) version of the ABCD questionnaire has good psychometric properties to assess CVD related knowledge and risk perception in the adult population. Based on the factor loadings and other psychometric properties, we suggested a shorter version, which has comparable psychometric properties.
| S-EPMC8076268 | biostudies-literature
Project description:Fractures of the hand and wrist are one of the most common injuries seen in adults. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire has been developed as a patient-reported assessment of pain and disability to evaluate the outcome after hand and wrist injuries. Patient reported outcomes (PROs) can be interpreted as pain, function or patient satisfaction. To be able to interpret clinical relevance of a PRO, the structural validity and internal consistency is tested. The Dutch version of the DASH has not yet been validated. The aim of this study was to evaluate the structural validity and the internal consistency of the existing Dutch version of the DASH. The relevance of reporting subscale scores was investigated.This study was a retrospective analysis of cross-sectional data of 370 patients with an isolated hand or wrist injury. Adult patients aged 18 to 65 years treated conservatively or surgically were included. Patients unable to understand or read the Dutch language were excluded. Confirmatory factor analysis was used to investigate the structural validity, while Cronbach's alpha and coefficient omega were used to assess internal consistency.All investigated models (a single factor model, a 3-correlated factor, and a bifactor model) were associated with a good model fit. Both the single factor and the 3-correlated factor model were associated with factor loadings of at least 0.70. In addition, the covariance between the factors in the 3-correlated factor model was positive (at least 0.89) and statistically significant (p?<?0.001). In the bifactor model, the additional value of subscales was limited as the items loaded high on the general factor but low on the subscale factors.This study indicates that the Dutch version of the DASH should be considered as an unidimensional trait. A single score should be reported.
| S-EPMC6026503 | biostudies-other
Project description:Introduction La pandémie du coronavirus a bouleversé les pratiques médicales avec une rupture de la continuité des soins et un retard diagnostic en oncologie avec des diagnostics à des stades plus avancés donc de plus mauvais pronostic. Nous nous sommes intéressés à l’impact de ce retard pour les mélanomes invasifs de stade précoce (stades I et II 8e classification AJCC). Matériel et méthodes Nous avons réalisé une étude rétrospective en région Rhône-Alpes, basée sur des données anatomopathologiques de Cypath-Dermapath (réseau de dermatopathologie privé drainant une large population hospitalière et libérale). Tous les nouveaux mélanomes cutanés primitifs invasifs diagnostiqués entre le 28 août 2019 et le 3 octobre 2020 étaient inclus. Les données analysées étaient cliniques : âge, sexe, topographie (tête/cou, membres supérieurs, membres inférieurs, tronc), et histologiques : épaisseur en mm, présence d’une ulcération, sous-type de mélanome (mélanome à extension superficielle, malin lentigineux, nodulaire, acrolentigineux, ou autre). Nous avons comparé les données sur 200 jours : pré-COVID-19 (28 août 2019 au 16 mars 2020) et COVID-19 (17 mars 2020 au 3 octobre 2020, le 17 mars 2020 date du premier confinement. Résultats Huit cent quatre vingt dix neuf mélanomes ont été inclus, 491 avant le confinement et 408 après. Le nombre de mélanome diagnostiqué par jour diminuait de 17 % après le confinement, surtout pendant le premier confinement du 17 mars 2020 au 12 mai 2020. Respectivement avant et après le confinement, l’âge moyen était de 62,3 ans et le Breslow moyen de 1,125 mm puis respectivement 64,7 ans et 1,194 mm. Les mélanomes ulcérés étaient plus fréquents après le confinement (11,8 %) qu’avant (7,5 %), p-value = 0,0311. Il n’était pas observé de différence significative entre les 2 périodes pour l’âge moyen, le sex-ratio, la topographie, l’épaisseur tumorale et le stade AJCC. L’analyse par classe d’âge montrait une tendance pour les plus jeunes, 18–44 ans, de mélanome plus épais après le confinement (0,78 mm contre 1,07 mm, p = 0,13) et plus souvent ulcéré (5,6 % contre 13,6 %, p = 0,15), avec plus de stade II AJCC après confinement (7,4 % contre 18,6 %, p = 0,099). Les autres classes d’âge, 45-65 et plus de 65 ans, ne montraient pas de différence significative. Discussion Notre étude ne montre pas un effet majeur de la pandémie à COVID-19 sur la sévérité des mélanomes diagnostiqués après le confinement. L’impact le plus notable apparaît chez les patients les plus jeunes, 18–44 ans, avec plus de stade II AJCC après le confinement qu’avant. Une étude sur une période plus longue permettra de préciser ces résultats.
| S-EPMC8603688 | biostudies-literature
Project description:Les trachéotomies, réalisées dans le cadre des syndromes de détresse respiratoire aigus sévères liés au COVID-19, sont des procédures à haut risque de dissémination virale. La technique percutanée pourrait diminuer ce risque car elle peut être effectuée au lit du patient et minimise l’ouverture des voies respiratoires, mais sa réalisation dans ce contexte COVID-19, chez des patients ayant une situation respiratoire précaire, nécessite une préparation spécifique. Nous avons construit une formation dédiée et fournissons ici les éléments nécessaires à sa réalisation. Un curriculum de 3 heures est proposé pour des internes et seniors ORL, comprenant un temps d’analyse vidéo, une démonstration du kit, l’habillage recommandé pour le COVID-19 et plusieurs scenarii de simulation de difficulté croissante sur mannequin haute-technologie. Un simulateur procédural basse-technologie est également proposé pour l’apprentissage des étapes du geste. Notre expérience (3 sessions de 14 participants) a permis de mettre en lumière les points difficiles de la procédure dans ce contexte, de définir une check-list pour la pratique clinique et une grille d’évaluation. Ce type de simulation permet de préparer les équipes à un acte technique potentiellement délicat.
| S-EPMC7284247 | biostudies-literature
Project description:ContextThe COVID-19 pandemic in France has led to the implementation of containment measures, limiting medical activity to urgent care. Heart Failure (HF) patients should have particularly been concerned. During the pandemic, movement restrictions and fear of contamination could have worsened HF patients.MethodsWe conducted two dedicated anonymous questionnaire completed at the end of the first lockdown period in France about the HF patients'symptoms and the cardiologists'pratice. In parallel, data from the SNDS (Système National des Données de Santé) were collected concerning the practices of cardiologists.ResultsRegarding HF patients, 1156 participated and filled the questionnaire. 53% were men, aged 61± 15 yo in men and 53±12 yo in women; 13% declared feeling bad during the pandemic period. 36% declared they had more dyspnea, 14% more oedema, 45% a gain of weight and 57% were more tired. 45% of patients declared having spent more than 4 weeks without any appointment with a medical doctor. Regarding Cardiologists, they proposed to perform a remotely follow-up (teleconsultation including visio, phone call management) in 23% of cases. In parallel, data from the SNDS showed that 19% of cardiologist used teleconsultations.ConclusionThrough this original survey, it emerges that despite the HF patients being more symptomatic, cardiological follow-up was difficult and challenging. We suggest that during pandemic, teleconsultations could improve the efficiency and quality of care, reduce demands on patients, and reduce healthcare costs.
| S-EPMC8432886 | biostudies-literature
Project description:Developed in the Norway, the Measure of Activity Performance of the Hand (MAP-Hand) assesses 18 activities performed using the hands. It was developed for people with rheumatoid arthritis (RA) using patient generated items, which are scored on a 0-3 scale and summarised into a total score range (0 to 54). This study reports the development and psychometric testing of the British English MAP-Hand in a UK population of people with RA.Recruitment took place in the National Health Service (NHS) through 17 Rheumatology outpatient clinics. Phase 1 (cross-cultural adaptation) involved: forward translation to British English; synthesis; expert panel review and cognitive debriefing interviews with people with RA. Phase 2 (psychometric testing) involved postal completion of the MAP-Hand, Health Assessment Questionnaire (HAQ), Upper Limb HAQ (ULHAQ), Short-Form 36 (SF-36v2) and Disabilities of the Arm Shoulder Hand (DASH) to measure internal consistency (Cronbach's alpha); concurrent validity (Spearman's correlations) and Minimal Detectable Difference (MDC95). The MAP-Hand was repeated three-weeks later to assess test-retest reliability (linear weighted kappa and Intra-Class Correlations (ICC (2,1)). Unidimensionality (internal construct validity) was assessed using (i) Confirmatory Factor Analysis (CFA) (ii) Mokken scaling and (iii) Rasch model. The RUMM2030 software was used, applying the Rasch partial credit model.In Phase 1, 31 participants considered all items relevant. In Phase 2, 340 people completed Test-1 and 273 (80%) completed Test-2 questionnaires. Internal consistency was excellent (??=?0.96). Test-retest reliability was good (ICC (2,1)?=?0.96 (95% CI 0.94, 0.97)). The MAP-Hand correlated strongly with HAQ20 (rs =?.88), ULHAQ (rs =?.91), SF-36v2 Physical Functioning (PF) Score (rs =?-.80) and DASH (rs =?.93), indicating strong concurrent validity. CFA failed to support unidimensionality (Chi-Square 236.0 (df 120; p <?0.001)). However, Mokken scaling suggested a probabilistic ordering. There was differential item functioning (DIF) for gender. Four testlets were formed, resulting in much improved fit and unidimensionality. Following this, testlets were further merged in pairs where opposite bias existed. This resulted in perfect fit to the model.The British English version of the MAP-Hand has good validity and reliability in people with RA and can be used in both research and clinical practice.
| S-EPMC6069818 | biostudies-other