Development of the Musculoskeletal Health Questionnaire (MSK-HQ) for Use in Different Conditions and Different Healthcare Pathways

Abstract

(word count 300) ObjectivesCurrent musculoskeletal outcome tools are fragmented across different healthcare settings and conditions. Our objectives were to develop and validate a single musculoskeletal outcome measure for use throughout the pathway and patients with different musculoskeletal conditions: the Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ). SettingA consensus workshop with stakeholders from across the musculoskeletal community, workshops and individual interviews with a broad mix of musculoskeletal patients identified and prioritised outcomes for MSK-HQ inclusion. Initial psychometric validation was conducted in four cohorts from community physiotherapy, and secondary care orthopaedic hip, knee and shoulder clinics. ParticipantsStakeholders (n=29) included primary care, physiotherapy, orthopaedic and rheumatology patients (n=8); general practitioners, physiotherapists, orthopaedists, rheumatologists and pain specialists (n=7), patient and professional national body representatives (n=10), and researchers (n=4). The four validation cohorts included 570 participants (n=210 Physiotherapy, n=150 Hip, n=150 Knee, n=60 Shoulder patients). Outcome measuresOutcomes included the MSK-HQ's acceptability, feasibility, comprehension, readability, and responder burden. The validation cohort outcomes were the MSK-HQ's completion rate, test-retest reliability and convergent validity with reference standards (EQ-5D-5L, Oxford Hip, Knee, Shoulder Scores, and the Keele MSK-PROM). ResultsMusculoskeletal domains prioritised were: pain severity, physical function, work interference, social interference, sleep, fatigue, emotional health, physical activity, independence, understanding, confidence to self-manage, and overall-impact. Patients reported MSK-HQ items to be 'highly relevant', and 'easy to understand'. Completion rates were high (94.2%), with scores normally distributed, and no floor/ceiling effects. Test-retest reliability was excellent, and convergent validity strong (correlations 0.81-0.88). ConclusionA new musculoskeletal outcome measure has been developed, through a co-production process with patients to capture prioritised outcomes for use throughout the pathway and with different musculoskeletal conditions. Four validation cohorts found the MSK-HQ had high completion rates, excellent test-retest reliability, and strong convergent validity with reference standards. Further validation studies are ongoing, including a cohort with rheumatoid/inflammatory arthritis. 3 Strengths and limitations of this study• A new musculoskeletal health questionnaire (MSK-HQ) has been successfully developed through a co-production process with patients • The MSK-HQ captures key outcomes that were shown to be highly relevant to patients across a range of musculoskeletal conditions and settings • Promising measurement properties were found in four different musculoskeletal cohorts, with high completion rates, excellent test-retest reliability, and strong convergent validity with reference standards ...

Nearly half of patients with chronic tendinopathy may have a neuropathic pain component, with significant differences seen between different tendon sites: a prospective cohort of more than 300 patients

“…In addition, the Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS)66 67 was completed to seek to identify patients who may have neuropathic pain component to their symptoms. Additional validated questionnaires were completed to assess the level of function overall, which were the 5-Level version of EuroQol-5 Dimension questionnaire68 69 as a marker of global health and functioning and the Musculoskeletal Health Questionnaire (MSK-HQ)70 71 as a measure of overall musculoskeletal functioning. Patient consent was gained at the time questionnaires were completed.…”

Evaluating the efficacy of Internet-Based Exercise programme Aimed at Treating knee Osteoarthritis (iBEAT-OA) in the community: a study protocol for a randomised controlled trial

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