Validity and Responsiveness of the Michigan Hand Questionnaire in Patients With Rheumatoid Arthritis: A Multicenter, International Study

University of Michigan Health System, Ann Arbor, 48109-5340, USA.
Arthritis care & research 11/2010; 62(11):1569-77. DOI: 10.1002/acr.20274
Source: PubMed


Millions of patients experience the disabling hand manifestations of rheumatoid arthritis (RA), yet few hand-specific instruments are validated in this population. Our objective was to assess the reliability, validity, and responsiveness of the Michigan Hand Questionnaire (MHQ) in patients with RA.
At enrollment and at 6 months, 128 RA patients with severe subluxation of the metacarpophalangeal joints completed the MHQ, a 37-item questionnaire with 6 domains: function, activities of daily living (ADL), pain, work, aesthetics, and satisfaction. Reliability was measured using Spearman's correlation coefficients between time periods. Internal consistency was measured using Cronbach's alpha. Construct validity was measured by correlating MHQ responses with the Arthritis Impact Measurement Scales 2 (AIMS2). Responsiveness was measured by calculating standardized response means (SRMs) between time periods.
The MHQ demonstrated good test-retest reliability (r = 0.66, P < 0.001). Cronbach's alpha scores were high for ADL (α = 0.90), function (α = 0.87), aesthetics (α = 0.79), and satisfaction (α = 0.89), indicating redundancy. The MHQ correlated well with AIMS2 responses. Function (r = -0.63), ADL (r = -0.77), work (r = -0.64), pain (r = 0.59), and summary score (r = -0.74) were correlated with the physical domain. Affect was correlated with ADL (r = -0.47), work (r = -0.47), pain (r = 0.48), and summary score (r = -0.53). Responsiveness was excellent among arthroplasty patients in function (SRM 1.42), ADL (SRM 0.89), aesthetics (SRM 1.23), satisfaction (SRM 1.76), and summary score (SRM 1.61).
The MHQ is easily administered, reliable, and valid to measure rheumatoid hand function, and can be used to measure outcomes in rheumatic hand disease.

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Available from: David Fox, Jan 27, 2015
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    • "The questionnaire assesses a patient’s perception to function, pain, satisfaction, and aesthetic appearance. The original MHQ has been used with almost all types of hand disorders, and its reliability, validity, and responsiveness has been validated for a range of upper extremity conditions, such as carpal tunnel syndrome, distal radius fractures, and rheumatoid arthritis (Chatterjee and Price, 2009; Kotsis et al., 2007; Roh et al., 2011; Waljee et al., 2010). The questionnaire itself consists of 57 items, and distinguishes between left and right hands over six domains, including overall hand function, activities of daily living, pain, work performance, aesthetics, and patient satisfaction with function. "
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