title: The Clinical Assessment Study of the Hand (CAS-HA): a prospective study of musculoskeletal hand problems in the general population.
abstract: BACKGROUND
  Pain in the hand affects an estimated 12-21% of the population, and at older ages the hand is one of the most common sites of pain and osteoarthritis. The association between symptomatic hand osteoarthritis and disability in everyday life has not been studied in detail, although there is evidence that older people with hand problems suffer significant pain and disability. Despite the high prevalence of hand problems and the limitations they cause in older adults, little attention has been paid to the hand by health planners and policy makers. We plan to conduct a prospective, population-based, observational cohort study designed in parallel with our previously reported cohort study of knee pain, to describe the course of musculoskeletal hand problems in older adults and investigate the relative merits of different approaches to classification and defining prognosis.
  
  
  METHODS
  All adults aged 50 years and over registered with two general practices in North Staffordshire will be invited to take part in a two-stage postal survey. Respondents to the survey who indicate that they have experienced hand pain or problems within the previous 12 months will be invited to attend a research clinic for a detailed assessment. This will consist of clinical interview, hand assessment, screening test of lower limb function, digital photography, plain x-rays, anthropometric measurement and brief self-complete questionnaire. All consenting clinic attenders will be followed up by (i) general practice medical record review, (ii) repeat postal questionnaire at 18-months, and (iii) repeat postal questionnaire at 3 years.
  
  
  CONCLUSIONS
  This paper describes the protocol for the Clinical Assessment Study of the Hand (CAS-HA), a prospective, population-based, observational cohort study of community-dwelling older adults with hand pain and hand problems based in North Staffordshire.
authors.affiliation: Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK. h.l.myers@cphc.keele.ac.uk
authors.forename: Helen
authors.initials: H
authors.lastname: Myers
authors.forename: Elaine
authors.initials: E
authors.lastname: Nicholls
authors.forename: June
authors.initials: J
authors.lastname: Handy
authors.forename: George
authors.initials: G
authors.lastname: Peat
authors.forename: Elaine
authors.initials: E
authors.lastname: Thomas
authors.forename: Rachel
authors.initials: R
authors.lastname: Duncan
authors.forename: Laurence
authors.initials: L
authors.lastname: Wood
authors.forename: Michelle
authors.initials: M
authors.lastname: Marshall
authors.forename: Catherine
authors.initials: C
authors.lastname: Tyson
authors.forename: Elaine
authors.initials: E
authors.lastname: Hay
authors.forename: Krysia
authors.initials: K
authors.lastname: Dziedzic
mesh_terms: D003430:Cross-Sectional Studies; D006225:Hand; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000503:physiopathology*; D010003:Osteoarthritis / Q000453:epidemiology / Q000503:physiopathology; D010146:Pain / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D011446:Prospective Studies