title: The relationship between therapist-rated function and patient-reported outcome measures.
abstract: METHODS
  Prospective cohort study.
  
  
  BACKGROUND
  Some third-party payers require hand therapists to rate patient's functional disability based on patient self-rating using patient-reported outcome measures (PROMs), objective measurements of impairment, and observation of functional tasks-hand therapist-rated function (HTRF).
  
  
  OBJECTIVE
  To test the correlation between HTRF and PROMs (upper limb functional index [ULFI] and Patient-Reported Outcomes Measurement Information System upper extremity [PROMIS UE]) and its association with psychological factors.
  
  
  METHODS
  In 2014, 100 new patients with upper extremity illness presenting to hand therapists were asked to participate in an observational cross-sectional study. Demographic-, condition-related, and psychological factors were obtained in addition to PROMs and HTRF.
  
  
  RESULTS
  HTRF correlated moderately with PROMIS UE (r = -0.49, P < .001) and ULFI (r = -0.56, P < .001). Correlation between PROMIS UE and ULFI was strong (r = 0.78, P < .001). Psychological factors explained most of the variations in both HTRF and PROMs.
  
  
  CONCLUSIONS
  Hand therapists' ratings of patient function correlate less strongly with PROMs than PROMs correlate with one other. The discrepancy between HTRF and PROMs may offer an opportunity to address stress, distress, or ineffective coping strategies that can interfere with recovery-an opportunity for therapists and patients to collaborate and develop goals and for future research to develop effective and feasible strategies for hand therapists.
  
  
  METHODS
  Level II, diagnostic study.
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Braun
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA.
authors.forename: Jos J
authors.initials: JJ
authors.lastname: Mellema
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA.
authors.forename: Rinne M
authors.initials: RM
authors.lastname: Peters
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Curley
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA.
authors.forename: Gae
authors.initials: G
authors.lastname: Burchill
authors.affiliation: Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX. Electronic address: DRing@partners.org.
authors.forename: David
authors.initials: D
authors.lastname: Ring
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D059352:Musculoskeletal Pain / Q000503:physiopathology / Q000534:rehabilitation*; D000072087:Occupational Therapists; D010147:Pain Measurement; D000071066:Patient Reported Outcome Measures; D011446:Prospective Studies; D011584:Psychology; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D018570:Risk Assessment
keywords: Hand therapy; Outcome measure; PROMIS upper extremity; Upper limb functional index