Recovery, responsiveness and interpretability of patient-reported outcome measures after surgery for Dupuytren’s disease

Abstract

II.

Sensitivity and specificity of the URAM scale for Dupuytren contracture: A systematic review and meta-analysis

“…MCID refers to the smallest change in status that patients consider important. Estimated MCID values for the URAM scale in the literature are 2.9 points for patients treated with NA (Beaudreuil et al 2011) and 10.5 points for those treated with open surgery (FSC or dermofasciectomy) (Rodrigues et al 2017). The results of our meta-regression analysis are consistent with these results, as we detected an improvement of 1.67 points in the URAM scale for each change in Tubiana stage (improvement of approximately 45º).…”

“…It is also consistent with the strong correlation observed between URAM and Tubiana scores in previous validations (Beaudreuil et al 2011) and with high sensitivity values reported for the DASH (Disabilities of the Arm, Shoulder and Hand) (82%) and QuickDASH (79%) questionnaires, although in these cases, meaningful change was measured using a very different methodology (Franchignoni et al 2014). The low diagnostic speci city observed (2.6%) is much lower than the rate reported for DASH (overall speci city, 74%) (Franchignoni et al 2014), although to our knowledge, the diagnostic accuracy of DASH has not yet been analyzed in the speci c setting of DC, but rather in studies analyzing different diseases (Gummesson et al 2006) or responsiveness to changes after corrective surgery for DC (Rodrigues et al 2017). Its diagnostic speci city for DC thus is unknown and is probably much lower than rates reported for general upper arm disabilities.…”

“…The theoretical advantage that the URAM scale offers over other scales is that it was designed to measure functional outcomes in DC, although its usefulness for assessing overall treatment outcomes has been questioned as it does not address aspects such as pain or cosmetic problems (Rodrigues et al 2017).…”

“…We are unable to compare our results with those for other scales such as DASH and QuickDASH, both validated for measuring outcomes in DC (Rodrigues et al 2017), as none of the studies analyzed detected MCIDs that reached the "o cial" clinically important change (The DASH outcome measure 2019) or other independently established thresholds (Franchignoni et al 2014). As indicated by a growing number of authors, thus, DASH, which is the most widely used tool for measuring treatment outcomes in DC, may not be the most useful tool for this purpose (Rodrigues et al 2017).…”

Measurement properties of the Dutch Unité Rhumatologique des Affections de la Main and its ability to measure change due to Dupuytren’s disease progression compared with the Michigan Hand outcomes Questionnaire

“…Despite possible objections, all these PROMs have been tested in Dupuytren’s populations ( Beaudreuil et al., 2011 ; Forget et al., 2014 ; Schoneveld et al., 2009 ; van de Ven-Stevens et al., 2015 ). The DASH was found to be unsuitable for application in this population since it lacked validity, discriminative ability and interpretability ( Forget et al., 2014 ; Rodrigues et al., 2017 ). The MHQ, which was tested in a Dutch Dupuytren’s population that had undergone percutaneous needle fasciotomy, had adequate construct validity and test–retest reliability ( Schoneveld et al., 2009 ).…”