gms | German Medical Science

Objectives/Interrogation: There has been an effort in medicine in general, and in hand surgery specifically to focus on a unified approach to outcome measures. The ability to analytically evaluate outcomes in hand surgery is critical for the understanding and sharing of results. It is fundamental to improvement and optimal tailoring of treatment regimens, personalizing treatment and ultimately to the advancement of the field. Despite its evident importance, the ability to do so has remained incomplete. This is due to the complexity of hand and wrist anatomy, mechanics, function, and individual functional requirements and expectations as well as a range of treatment options including conservative and surgical options.

Methods: Currently utilized evaluations are constrained in their ability to determine exact function, and thus have limited capacity to identify specific functional deficits and personal needs. The availability of multiple functional tests, each addressing a specific function and rarely standardized, further complicates outcomes evaluation. Existing measures allow us to evaluate and compare a specific outcome such as grip strength, motion, or the patient's perception of his or her function, but a global picture of the outcome that combines these factors and incorporates a functional measure remains elusive.

Results and Conclusions: We are in the process of utilizing a multidisciplinary approach that includes hand surgeons, hand therapists and clinical trial specialists to determine predefined outcome measures that can be combined and weighted into a single score for the evaluation of wrist conditions. An international forum of experts in this field has been assembled and will meet on the 21st of November 2018 in Switzerland with the aim of establishing a comprehensive single scoring system for wrist outcomes.

Further plans include clinical trials utilizing this "consensus tool" and refinement of the tool as we accumulate experience with it. Ultimately, it is our aim to have a tool that will allow comparison of outcomes for both surgical procedures and therapeutic interventions for wrist conditions. We believe it is important to promote awareness of the challenge in creating and implementing consistent evaluation measures and the efforts to address it in our respective societies (hand surgeons and hand therapists).