A systematic search and critical review of measures of disability for use in a population survey of hand osteoarthritis (OA).
OBJECTIVE
In order to develop a hand assessment questionnaire for a population survey, a systematic review was undertaken of measures of hand disability. The purpose of this review was to identify valid measures to evaluate hand osteoarthritis (HOA) in the general population and primary care and to perform a quality appraisal of them.


METHODS
Measurement tools were identified from an online search of databases (Medline, CINAHL and Institute for Scientific Information (ISI), 1990-2002) restricted to English language and adult population. Search terms combined "osteoarthritis" and "arthritis" with "hand" and ["function" or "disability" or "outcome"]. Instruments used in the evaluation of HOA were identified following application of strict eligibility criteria. The use of these tools in HOA was rated by pairs of independent reviewers according to criteria developed by the Medical Outcomes Trust.


RESULTS
The initial search yielded a list of articles which were not mutually exclusive (ISI, 127; Medline, 64; CINAHL, 61). Full journal articles were ordered from relevant abstracts (ISI, 28; Medline, 3; CINAHL, 5). Further hand searching of articles produced an additional 34 references. A total of 61 references were identified, 18 measurement tools, 5 of which met the inclusion criteria [Algofunctional Index (FIHOA), Arthritis Impact Measurement Scale 2 (AIMS2), Stanford Health Assessment Questionnaire (HAQ), Australian/Canadian Osteoarthritis Hand Index (AUSCAN), Cochin]. Overall, the AIMS2 and AUSCAN were more highly rated than the FIHOA, Cochin and HAQ.


CONCLUSIONS
The aim of this review was not to recommend any one instrument over another but to provide an overall summary of the robustness of commonly used measures. The choice of instrument will depend on many factors, and will differ from project to project depending on the question asked.
Dziedzic
K S
KS
Primary Care Sciences Research Centre, Keele University, Keele, Staffordshire ST5 5BG, UK. k.s.dziedzic@keele.ac.uk
Thomas
E
E
Hay
E M
EM
D000368:Aged; D004185:Disability Evaluation; D006225:Hand; D006801:Humans; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis*; D011379:Prognosis; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires