The Minimal Clinically Important Difference of the Michigan Hand Outcomes Questionnaire

Section of Plastic Surgery, Department of Surgery, The University of Michigan Health System, Ann Arbor, MI 48109-0340, USA.
The Journal of hand surgery (Impact Factor: 1.67). 03/2009; 34(3):509-14. DOI: 10.1016/j.jhsa.2008.11.001
Source: PubMed


To determine the change in score required in various domains of the Michigan Hand Outcomes Questionnaire (MHQ) to indicate meaningful patient improvement, or the minimal clinically important difference (MCID), for 3 common hand conditions: rheumatoid arthritis (RA), carpal tunnel syndrome (CTS) and distal radius fracture (DRF).
The MHQ was administered to patients at 2 time points. Patient satisfaction was defined as a satisfaction score > or =80% of the standard deviation of that patient sample. The minimal change in score in specific MHQ domains that corresponded with patient satisfaction was determined using receiver operating characteristic curves.
For CTS patients, MCIDs of 23, 13, and 8 were identified for the pain, function, and work domains, respectively. For RA patients, pain and function were also identified as having discriminative ability, with MCIDs of 11 and 13, respectively. An MCID of 3 was identified for the activities of daily living domain. For DRF patients, no MHQ domains showed discriminative ability because of the ceiling effect at the 3-month assessment period.
Individual domains of the MHQ can be used to discriminate between patients who are satisfied and those who are not after either carpal tunnel release or silicone arthroplasty of the metacarpophalangeal joints for RA. Pain and function are the domains of the MHQ that are best able to discriminate between patients who are satisfied and those who are not. The identical function MCID for both RA patients and CTS patients, despite markedly different preoperative values, indicates that a standard amount of functional change may indicate patient satisfaction. High postoperative satisfaction, even only 3 months after surgery, prevented any domains from showing discriminative ability for the DRF patients.

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    • "that were included in the analysis (Figure 1) (Adams et al., 2012; Amirfeyz et al., 2009; Atroshi et al., 2011; Beaton et al., 2001b; Beaton et al., 2011; Beaudreuil et al., 2011; Bessette et al., 1998; Dawson et al., 2008; Franchignoni et al., 2014; Gummesson et al., 2003; Katz et al., 1994; Kim and Jeon, 2013; Kim and Park, 2013; Levine et al., 1993; London et al., 2014; Malay and Chung, 2013; Mintken et al., 2009; Ozer et al., 2013; Ozyurekoglu et al., 2006; Polson et al., 2010; Poltawski and Watson, 2011; Schmitt and Di Fabio, 2004; Shauver and Chung, 2009; Sorensen et al., 2013; Spies-Dorgelo et al., 2006; Tashjian et al., 2009; van der Giesen et al., 2008; Waljee and Chung, 2012; Witthaut et al., 2011). During the manual search, one other MID estimation was identified in a reference from a review article (Carswell et al., 2004). "
    Dataset: JHS553908

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