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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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The Patient Specific Functional Scale in Dupuytren’s disease – a more responsive outcome measure than standardized PROMS?

Meeting Abstract

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  • presenting/speaker Yara Van Kooij - Handtherapie Nederland, Utrecht, Netherlands
  • Ralph Poelstra - Department of Plastic, Reconstructive and Hand Surgery, Department of Rehabilitation Medicine, Hand and Wrist Centre, Xpert Clinic, Rotterdam, Netherlands
  • Jarry Porsius - Department of Plastic, Reconstructive and Hand Surgery, Department of Rehabilitation Medicine, Rotterdam, Netherlands
  • Harm Slijper - Hand and Wrist Centre, Xpert Clinic, Hilversum, Netherlands
  • David Warwick - University Hospital Southampton, Southampton, United Kingdom
  • Ruud Selles - Department of Plastic, Reconstructive and Hand Surgery, Department of Rehabilitation Medicine, Rotterdam, Netherlands

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-407

doi: 10.3205/19ifssh0859, urn:nbn:de:0183-19ifssh08598

Published: February 6, 2020

© 2020 Van Kooij et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Due to the wide variety of functional problems of patients with Dupuytren's disease, standardized patient-reported outcome measures (PROMs) may fail to capture all problems these patients experience. Individualized PROMs might overcome this problem by enabling patients to specify and rate those activities with which they have difficulty in daily life. The Patient Specific Functional Scale (PSFS) is such an individualized PROM and is easy and relatively quick to use. The aim of this study is to determine the responsiveness of the PSFS compared to the Michigan Hand Questionnaire (MHQ) in patients with Dupuytren's disease.

Methods: Patients treated for Dupuytren's disease were asked to fill in the PSFS and the MHQ prior to surgery and three months after treatment. For the PSFS, patients were asked to identify and score three to five important activities they experienced difficulties with due to Dupuytren's disease. Activities were scored on an 11-point scale with '0' representing 'unable to perform' and '10' representing 'able to perform at prior-disease level'. At follow-up, the patients are presented with the same activities again and ask to rate the ability for each activity. Cohen's D effect sizes were calculated to assess the responsiveness to change.

Results and Conclusions: A total of 308 patients was included. Patients mentioned a wide variety of functional problems of which the majority (e.g. computer use) was not covered by standardized PROMs like the MHQ. The mean PSFS score improved significantly from 5.0 at baseline to 7.7 at follow-up. The effect size of the PSFS was 1.0 (95% confidence interval 0.86-1.2), which was significantly higher and almost double the responsiveness of the MHQ (0.58; 95% confidence interval 0.42-0.74) of the MHQ.

This study demonstrates that the PSFS is more responsive to change compared to the MHQ in patients with Dupuytren's disease. Self-generated items and the measurement of such items truly reflect the needs and problems of the individual patient. These characteristics make the PSFS a valuable outcome measure for Dupuytren's disease and this fits well within the current emphasis of patient-centred healthcare.