Assessment of construct validity of the Finnish versions of the Disabilities of Arm, Shoulder and Hand Instrument and the Michigan Hand Outcomes Questionnaire

Abstract

Study Design: Cross-sectional study.

Introduction: There is a lack of information on the measurement properties of patient-reported upperextremity instruments and their association to health-related quality of life (HRQoL).

Purpose of the Study: This study aimed to examine and compare the measurement properties andconstruct validity of the Disabilities of Arm, Shoulder, and Hand (DASH) Instrument and the MichiganHand Questionnaire (MHQ) using a heterogeneous sample of patients with hand and wrist problems.

Methods: Two hundredfifty consecutive patients visiting a general orthopedic outpatient clinic due tovarious hand/wrist problems were invited to participate in the study. A total of 193 (77%) participantsprovided sufficient patient-reported outcome data and were included in the analysis. Participantscompleted the DASH, the MHQ, the EQ-5D-3L, and pain on a visual analog scale instruments. Grip andkey pinch forces were measured. Scale targeting, relatedness of demographics, and construct validity ofthe DASH and the MHQ were assessed.

Results: Both the DASH and the MHQ had good targeting, but the DASH had wider coverage. Theconvergence between the DASH and the MHQ was high. The DASH was more closely related to HRQoLthan the MHQ in terms of EQ-5D scores.

Discussion: The DASH instrument appeared to measure hand function and disability from a perspective ofHRQoL superior to the MHQ among patients with heterogeneous hand and wrist complaints.

Conclusion: The DASH performs well in measuring the HRQoL-related hand outcomes while the MHQmight be more specific for the affected hand.