Dimensionality and clinical importance of pain and disability in hand osteoarthritis: Development of the Australian/Canadian (AUSCAN) Osteoarthritis Hand Index.
OBJECTIVE
To develop a reliable, valid, and responsive self-administered questionnaire to probe pain, stiffness and physical disability in patients with osteoarthritis (OA) of the hand.


METHODS
In order to assess the dimensionality of the symptomatology of hand OA, a self-administered questionnaire was developed to probe various aspects of pain (10 items), stiffness (two items), and physical function (83 items). The question inventory was generated from eight existing health status measures and an interactive process involving four rheumatologists, two physiotherapists, and an orthopaedic surgeon.


RESULTS
Face-to-face interviews were conducted with 50 OA hand patients; 39 females and 11 males with mean age 62.8 years and mean disease duration 9.4 years. Items retained were those which fulfilled specified selection criteria: prevalence > or =60% and mean importance score approximating or exceeding 2.0 Item exclusion criteria included low prevalence, gender-based, ambiguous, duplicates or similarities, alternatives, composite items, and items that were too restrictive. This process resulted in five pain, one stiffness and nine function items which have been proposed for incorporation in the AUSCAN Index.


CONCLUSIONS
Using a traditional development strategy, we have constructed a self-administered multi-dimensional outcome measure for assessing hand OA. The next stage includes reliability, validity and responsiveness testing of the 15-item questionnaire.
Bellamy
N
N
The Faculty of Health Sciences, The University of Queensland, Herston, Australia. nbellamy@medicine.uq.edu.au
Campbell
J
J
Haraoui
B
B
Buchbinder
R
R
Hobby
K
K
Roth
J H
JH
MacDermid
J C
JC
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D007596:Joints / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D010003:Osteoarthritis / Q000503:physiopathology*; D010147:Pain Measurement / Q000379:methods*; D012648:Self Care / Q000379:methods; D011795:Surveys and Questionnaires