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

Abstract

Background The URAM (Unité Rhumatologique des Affections de la Main) scale is a patient-reported functional outcome measurement tool validated for exclusive use in Dupuytren contracture (DC) a condition in which one or more fingers become permanently bent in a flexed position. The current study´s purposes were to evaluate: How sensitive and specific is the URAM scale for defining quality of life in patients with in DC and how sensitive to change is the URAM scale after treatment. Methods We performed a meta-analysis of all relevant articles published in PubMed, Embase, Cochrane, Google Scholar, LILACS and in various gray literature databases that describe the use of the URAM. We built three models: a hierarchical summary receiver operating characteristic (HSROC) model to determine the optimal threshold for defining DC, a difference in means models to assess the magnitude of the effect of different treatment modalities, and a meta-regression model to determine the effect on patient quality of life questionnaires according to variations in Tubiana scores after treatment (URAM). Results The HSROC and bivariate models showed a sensitivity of 80.23% (95%CI: 75.66 to 84.14) and an overall specificity of 2.61% (95%CI: 1.11–6.05). The second model showed an overall difference in means of 1.95 (95%CI: -2.86 to -1.04). The coefficient obtained in the meta-regression model was − 1.666 (95%CI: -4.183 to 0.851). Conclusion The URAM scale is highly sensitive to changes in DC but has low specificity. It also showed a strong correlation with worsening of finger contracture.