Schulthess Klinik, Department of Teaching, Research and Development, Lengghalde 2, 8008 Zürich, Switzerland.
Schulthess Klinik, Department of Hand Surgery, Lengghalde 2, 8008 Zürich, Switzerland.
Hand Surg Rehabil. 2020 Dec;39(6):568-574. doi: 10.1016/j.hansur.2020.05.008. Epub 2020 Jul 8.
We sought to investigate the reliability, validity, responsiveness, and interpretability of the German version of the Unité Rhumatologique des Affections de la Main (URAM) scale in patients with Dupuytren's disease. Patients with Dupuytren's disease were evaluated before receiving an injection of collagenase Clostridium histolyticum or undergoing surgical treatment and again 1 year later. Patients completed the URAM, the brief Michigan Hand Outcomes Questionnaire (brief MHQ), and the 5-level EuroQol version (EQ-5D-5L). Flexion contracture was measured. Internal consistency (Cronbach's alpha), construct validity (Spearman's correlation coefficient, r), responsiveness (effect size), and the minimally important change (MIC) and minimally important difference (MID) were determined. Confirmatory factor analysis was used to test the structural validity of the questionnaire. We included 231 patients (273 cases) with a mean age of 67 (SD, 9) years. Cronbach's alpha was 0.91. Correlations between the URAM and the brief MHQ, EQ-5D-5L and flexion contracture were r=-0.76, r=-0.46 and r=0.53, respectively. The URAM effect size was 0.96 and the MIC and MID were 6 and 7 points, respectively. The factor analysis revealed unidimensionality but indicated that one item (pick up small objects) could be removed. The German URAM has high reliability, good construct validity and excellent responsiveness. However, the questionnaire could be shortened by one item to increase its structural validity. We recommend using the URAM as a specific tool for evaluating the treatment effect in patients with Dupuytren's disease in daily practice and for research purposes.
我们旨在探究德国版的 Dupuytren 疾病手部功能评定量表（URAM）在 Dupuytren 病患者中的可靠性、有效性、反应度和可诠释性。在接受胶原酶注射或手术治疗前和 1 年后，Dupuytren 病患者接受了评估。患者完成了 URAM、简明密歇根手部问卷（brief MHQ）和 5 级欧洲五维健康量表（EQ-5D-5L）。测量了掌曲挛缩程度。采用 Cronbach's alpha 评估内部一致性，Spearman 相关系数（r）评估结构效度，效应量（effect size）评估反应度，最小临床重要变化（MIC）和最小临床差异（MID）评估可诠释性。采用验证性因子分析评估问卷的结构效度。我们纳入了 231 名患者（273 例），平均年龄 67（标准差 9）岁。URAM 的 Cronbach's alpha 为 0.91。URAM 与 brief MHQ、EQ-5D-5L 和掌曲挛缩的相关性分别为 r=-0.76、r=-0.46 和 r=0.53。URAM 的效应量为 0.96，MIC 和 MID 分别为 6 和 7 分。因子分析表明具有单维性，但表明可删除 1 项（捡起小物体）。德国版 URAM 具有较高的可靠性、良好的结构效度和出色的反应度。然而，可通过删除 1 项来缩短问卷，以增强其结构效度。我们建议在日常实践中以及研究中，将 URAM 作为评估 Dupuytren 病患者治疗效果的专用工具。
