title: Comparison of functional outcome scores in radial polydactyly.
abstract: BACKGROUND
  A wide range of outcome assessment systems have been used to describe the results and evaluate residual impairment after surgery for radial polydactyly. We conducted a study to determine which of these assessment systems should be considered superior for the most common types of radial polydactyly (types II and IV).
  
  
  METHODS
  Ten outcome assessment systems were selected. Three examiners independently evaluated thirty-seven patients, aged four to twenty-two years, with radial polydactyly. Patients completed two manual activity questionnaires. Interobserver reliability was determined with use of an intraclass correlation coefficient (ICC). Validity was assessed by correlating the results derived with the outcome assessment systems with functional visual analog scale (VAS), aesthetic VAS, and manual activity questionnaire scores.
  
  
  RESULTS
  Thirty-seven patients (forty-one hands with radial polydactyly) were evaluated. All patients were assessed by at least two examiners. Reliability was highest for the Japanese Society for Surgery of the Hand (JSSH), Cheng et al., and Tada et al. assessment systems (overall ICCs ≥ 0.70). The JSSH system had the highest overall correlations (rs ranging from 0.48 to 0.80 and 0.45 to 0.63) with functional and aesthetic VAS scores. No significant correlations were found between the outcome scores and the results of the manual activity questionnaires after an average follow-up time of 112 months.
  
  
  CONCLUSIONS
  Interobserver reliability was highest for the JSSH classification, which also showed superior correlations with both examiner-rated and patient-rated VAS scores for functional and aesthetic outcome compared with the other nine assessment systems. The finding of a poor correlation between the outcome scores and the results of manual activity questionnaires is in agreement with findings in published literature. We recommend the JSSH assessment method for the scientific evaluation of the outcomes, in terms of body structure and function, of the treatment of radial polydactyly.
authors.affiliation: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, P.O. Box 2040, Room EE.15.91, 3000 CA Rotterdam, the Netherlands. E-mail address for R.R. Dijkman: r.dijkman@erasmusmc.nl. E-mail address for R.W. Selles: r.selles@erasmusmc.nl.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Dijkman
authors.affiliation: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, P.O. Box 2040, Room HS 511, 3000 CA Rotterdam, the Netherlands. E-mail address: c.vannieuwenhoven@erasmusmc.nl.
authors.forename: Christianne A
authors.initials: CA
authors.lastname: van Nieuwenhoven
authors.affiliation: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, P.O. Box 2040, Room EE.15.91, 3000 CA Rotterdam, the Netherlands. E-mail address for R.R. Dijkman: r.dijkman@erasmusmc.nl. E-mail address for R.W. Selles: r.selles@erasmusmc.nl.
authors.forename: Ruud W
authors.initials: RW
authors.lastname: Selles
authors.affiliation: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, P.O. Box 2040, Room HS 501, 3000 CA Rotterdam, the Netherlands. E-mail address: s.e.r.hovius@erasmusmc.nl.
authors.forename: Steven E R
authors.initials: SE
authors.lastname: Hovius
mesh_terms: D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010147:Pain Measurement; D017689:Polydactyly / Q000601:surgery*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D016896:Treatment Outcome