Psychometric Properties of Health-Related Quality of Life Instruments in Patients Undergoing Palmar Fasciectomy for Dupuytren's Disease: A Prospective Study

BACKGROUND: The traditional outcome measured following treatment of Dupuytren's Disease (DD) has been digital range of motion; specifically the gain in digital extension. The outcomes research movement in the last three decades however has been advocating the measurement of outcomes from the patient's perspective using Health-Related Quality of Life questionnaires (HRQOL). Although several generic and region-specific HRQOL questionnaires exist, there is no guidance as to which one is the most appropriate for this population. The objective of this study is to evaluate the psychometric properties of three self-reported HRQOL outcome measures in patients with DD. METHODS: Patients with DD were enrolled from the practices of three plastic surgeons. Test-retest reliability, concurrent validity and responsiveness of three HRQOL questionnaires were compared in a prospective study design. The HRQOL measures included Health Utilities Index Mark 3 (HUI3), Short Form-36 (SF-36), and the Michigan Hand Questionnaire (MHQ). RESULTS: All three measures demonstrated good test-retest reliability (ICC = 0.77-0.85). Concurrent validity was found between the HUI3 pain and dexterity attributes and SF-36 physical summary score. The sensitivity of the MHQ to detect changes in the status of the patient was found to be high (effect size = 1.14) whereas that of the SF-36 was trivial. CONCLUSIONS: The HUI3 and the MHQ seem to be reliable and valid tools to assess the HRQOL in patients with Dupuytren's Disease.