Sears Erika Davis, Chung Kevin C
Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI 48109-5340, USA.
J Hand Surg Am. 2010 Jan;35(1):30-7. doi: 10.1016/j.jhsa.2009.09.008. Epub 2009 Dec 2.
The aim of this study was to demonstrate the validity and responsiveness of the Jebsen-Taylor Hand Function Test (JTT) in measuring hand function in patients undergoing hand surgery, compared with the Michigan Hand Outcomes Questionnaire (MHQ).
A prospective cohort of patients with rheumatoid arthritis (n = 37), osteoarthritis (n= 10), carpal tunnel syndrome (n = 18), and distal radius fracture (n = 46) were evaluated preoperatively and at 9 to 12 months of follow-up. We administered the JTT and MHQ. We performed correlation and receiver operating characteristic analyses to evaluate the validity of the JTT as a measure of disability. Effect size and standardized response means were calculated to determine responsiveness.
Correlation studies revealed poor correlation of the JTT with MHQ total scores and subsets that relate to hand function. Patients with high MHQ scores generally perform well on the JTT; however, patients with good JTT scores do not necessarily have high MHQ scores. Receiver operating characteristic curves for each condition showed that the change in JTT total score had poor ability to discriminate between high and low MHQ score subjects, with an area under the curve result of 0.52 to 0.66 for each condition. Effect size and standardized response means for all states showed greater responsiveness with the MHQ for each condition compared with the JTT.
We found poor correlation between the change in JTT and absolute JTT scores after surgery compared with change in MHQ and absolute MHQ scores. In addition, the JTT had poor discriminant validity based on the MHQ as a reference. This study showed that the time to complete activities does not correlate well with patient-reported outcomes. We conclude that the JTT should not be used as a measure of disability or clinical change after surgical intervention.
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic III.
本研究旨在与密歇根手部结果问卷(MHQ)相比,证明杰布森 - 泰勒手部功能测试(JTT)在测量接受手部手术患者的手部功能时的有效性和反应性。
对一组前瞻性队列患者进行研究,其中类风湿性关节炎患者(n = 37)、骨关节炎患者(n = 10)、腕管综合征患者(n = 18)和桡骨远端骨折患者(n = 46)在术前以及随访9至12个月时接受评估。我们实施了JTT和MHQ测试。我们进行了相关性分析和受试者工作特征分析,以评估JTT作为残疾测量指标的有效性。计算效应量和标准化反应均值以确定反应性。
相关性研究表明,JTT与MHQ总分以及与手部功能相关的子量表之间的相关性较差。MHQ得分高的患者在JTT测试中通常表现良好;然而,JTT得分高的患者不一定具有高MHQ得分。每种情况的受试者工作特征曲线表明,JTT总分的变化区分高和低MHQ得分受试者的能力较差,每种情况的曲线下面积结果为0.52至0.66。与JTT相比,所有状态下的效应量和标准化反应均值显示,每种情况使用MHQ时的反应性更高。
我们发现,与MHQ的变化和绝对MHQ得分相比,术后JTT的变化与绝对JTT得分之间的相关性较差。此外,以MHQ为参考,JTT的判别效度较差。本研究表明,完成活动的时间与患者报告的结果相关性不佳。我们得出结论,JTT不应作为手术干预后残疾或临床变化的测量指标。
研究类型/证据水平:诊断性研究III级