Sensitivity to change of the functional index for hand osteoarthritis.
BACKGROUND
The functional index for hand osteoarthritis (FIHOA), a 10-item investigator-administered questionnaire, was validated in 1995. It is relevant, reliable and has good external and internal validities.


OBJECTIVE
To assess the sensitivity to change over time of the FIHOA.


METHODS



METHODS
symptomatic [visual analog scale (VAS) > or = 30 mm, FIHOA > or = 5] hand OA patients [American College of Rheumatology (ACR) criteria, > or = 2 radiologically affected joints] were included in a 6-month randomized, double-blind, placebo-controlled trial. Recorded parameters: Pain on VAS, FIHOA score, morning stiffness duration, grip strength.


METHODS
mean standardized response (MSR = delta DO-M6/S.D. of delta) was calculated for each parameter in an intention-to-treat (ITT) population before breaking the randomization code.


RESULTS
239 women, 22 men, mean age 61 +/- 7.5 years were recruited. Characteristics of HOA: 88% of patients were right-handed, 48% had a family history of hand OA. The location of OA was the first trapezo-metacarpal (TMC) joint (62%), proximal interphalangeal (PIP) joint (47.5%), distal interphalangeal (DIP) joint (67.6%). The mean number of painful flares (previous 12 months) was 4.4, that of painful joints was 3.7, that of nodal joints in the right hand 3.1, and that of radiologically affected joints was 4.4. Baseline symptomatic severity assessment gave pain on VAS=54.4 +/- 14 mm, FIHOA score=10.4 +/- 3.7, morning stiffness duration=20 +/- 27.6 min and grip strength=59.3 +/- 21.2 mm Hg. The MSR value was 0.58 for the FIHOA and 0.87 for pain on VAS.


CONCLUSIONS
The sensitivity to change of the FIHOA over 6 months is high, but inferior to that of pain on VAS in this trial.
Dreiser
R L
RL
Service de Rhumatologie, H pital Bichat, Paris, France.
Maheu
E
E
Guillou
G B
GB
D000203:Activities of Daily Living; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006227:Hand Deformities, Acquired / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D010003:Osteoarthritis / Q000175:diagnosis* / Q000188:drug therapy; D010147:Pain Measurement; D010936:Plant Extracts / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome
D010936:Plant Extracts