Comparing the AUSCAN Osteoarthritis Hand Index, Michigan Hand Outcomes Questionnaire, and Sequential Occupational Dexterity Assessment for Patients with Rheumatoid Arthritis

NICOLA MASSY-WESTROPP, JEGAN KRISHNAN, and MICHAEL AHERN

ABSTRACT.

Objective. The Australian Canadian Osteoarthritis Hand Index (AUSCAN), Michigan Hand Outcomes Questionnaire (MHQ), and the Sequential Occupational Dexterity Assessment (SODA) are assessments of hand function. Investigation of psychometric properties, administration, acceptability, and content of an assessment add strength to the findings of research and treatment. We evaluated the validity and reliability of the AUSCAN, MHQ, and the SODA for assessing disability in patients with rheumatoid arthritis (RA).

Methods. Sixty-two patients with RA completed the AUSCAN (visual analog scale version), the MHQ, and the SODA. Seventeen patients repeated the assessments within one week.

Results. The assessments recorded high variability within the sample of 62 patients with RA. The AUSCAN and MHQ provided patient and context-specific information, while the SODA provided more impairment information that could be readily compared between patients. Seventeen patients were tested twice within 5 days, showing good reliability of all assessments. Unlike the MHQ, AUSCAN and SODA do not provide information about individual hands or hand dominance. The physical function scales of the AUSCAN and the SODA were related (r = 0.81), and the AUSCAN and MHQ pain scales were related (r = 0.68).

Conclusion. Clinicians and researchers should decide whether impairment, ability, or handicap outcome is the goal of assessment, and whether bilateral function or the function of one hand is of interest before choosing a hand assessment. The AUSCAN and MHQ are valid and reliable for assessment of hand disability in patients with RA, and they allow the patients to answer questions about their home environment. The SODA is also valid and reliable for assessing disability in a clinical situation that cannot be generalized to the home. (J Rheumatol 2004;31:1996-2001)

Key Indexing Terms:

RHEUMATOID ARTHRITIS
HAND
QUESTIONNAIRES

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From Flinders University; the Department of Orthopaedic Surgery, Flinders Medical Centre; and Repatriation General Hospital, Daw Park, Adelaide, Australia.

Supported by a postgraduate award from Flinders University, Adelaide, and a grant from the National Health and Medical Research Council of Australia.

N. Massy-Westropp, M. Health, PhD Candidate; J. Krishnan, PhD, FRACS, Professor, Director, Department of Orthopaedic Surgery; M. Ahern, PhD, FRACP, Associate Professor, Division of Medicine, Flinders Medical Centre and Repatriation General Hospital.

Address reprint requests to N. Massy-Westropp, Flinders Medical Centre and Repatriation General Hospital, Department of Orthopaedic Surgery, Daw Road, Daw Park, Australia 5041.

Submitted September 5, 2003; revision accepted April 15, 2004.

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