Psychometric properties of health-related quality of life instruments in patients undergoing palmar fasciectomy for dupuytren's disease: a prospective study.
BACKGROUND
The traditional outcome measured following treatment of Dupuytren's Disease (DD) has been digital range of motion; specifically the gain in digital extension. The outcomes research movement in the last three decades however has been advocating the measurement of outcomes from the patient's perspective using Health-Related Quality of Life questionnaires (HRQOL). Although several generic and region-specific HRQOL questionnaires exist, there is no guidance as to which one is the most appropriate for this population. The objective of this study is to evaluate the psychometric properties of three self-reported HRQOL outcome measures in patients with DD.


METHODS
Patients with DD were enrolled from the practices of three plastic surgeons. Test-retest reliability, concurrent validity and responsiveness of three HRQOL questionnaires were compared in a prospective study design. The HRQOL measures included Health Utilities Index Mark 3 (HUI3), Short Form-36 (SF-36), and the Michigan Hand Questionnaire (MHQ).


RESULTS
All three measures demonstrated good test-retest reliability (ICC = 0.77-0.85). Concurrent validity was found between the HUI3 pain and dexterity attributes and SF-36 physical summary score. The sensitivity of the MHQ to detect changes in the status of the patient was found to be high (effect size = 1.14) whereas that of the SF-36 was trivial.


CONCLUSIONS
The HUI3 and the MHQ seem to be reliable and valid tools to assess the HRQOL in patients with Dupuytren's Disease.
Division of Plastic Surgery, Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, ON Canada ; Surgical Outcomes Research Centre, Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, ON Canada ; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON Canada ; Suite 101, 206 James Street South, Hamilton, ON Canada L8P 3A9.
Achilleas
A
Thoma
Division of Plastic Surgery, Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, ON Canada ; Surgical Outcomes Research Centre, Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, ON Canada.
Manraj Nirmal
MN
Kaur
Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, ON Canada.
Teegan Aili
TA
Ignacy
Division of Plastic Surgery, Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, ON Canada.
Carolyn
C
Levis
Division of Plastic Surgery, Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, ON Canada.
Stuart
S
Martin
Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON Canada.
Eric
E
Duku
Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON Canada.
Ted
T
Haines
Dupuytren’s Disease; Outcomes; Palmar fasciectomy; Quality of life