School of Rehabilitation Science, McMaster University, 1400 Main Street West IAHS 403, Hamilton, ON, L8S 4L8, Canada.
Physical Therapy and Surgery, Western University, London, ON, Canada.
BMC Musculoskelet Disord. 2022 Jun 8;23(1):551. doi: 10.1186/s12891-022-05478-4.
The brief Michigan Hand Questionnaire (brief MHQ) is a 12-item self-reported measure of hand function for patients with hand disorders which has been validated using Classical Test Theory. Rasch analysis can provide more detailed psychometric information. The purpose of this Rasch analysis is to assess the psychometric properties of the brief MHQ for patients with thumb osteoarthritis, and to make recommendations for improvements to the questionnaire if needed. METHODS: The Michigan Hand Questionnaire and demographic data were collected from 923 thumb osteoarthritis patients treated in specialized clinics for hand surgery and therapy in the Netherlands. Rasch analysis was performed on the 12 items of the brief MHQ using RUMM 2030 to assess the fit of the brief MHQ to the Rasch model. To determine fit, analysis of fit summary statistics, individual person fit and individual item fit were assessed. Threshold distributions were assessed to identify if any items required rescoring. The Person Separation Index was calculated to measure reliability of the questionnaire. Differential item functioning was assessed to identify item bias, and Principal Component Analysis was performed to identify unidimensionality and local dependence.
The brief MHQ showed misfit (χ = 1312.5, p < 0.0001) with 6 items having disordered thresholds and 9 items requiring rescoring. After deleting 3 of the rescored items due to significant item fit residuals, the brief MHQ had an acceptable reliability (Cronbach's alpha = 0.79). Misfit to the model (χ = 49.6, p = 0.0001), multidimensionality (10.2% of t-tests were significant), and item bias from non-uniform differential item functioning for 7 items across many person variables were still found.
Although no satisfactory solutions were found to correct the misfit to the Rasch model, it is recommended that the response options of the brief MHQ be rescored, and that items 6, 9 and 10 be removed. The lack of unidimensionality indicates that the items do not represent the singular construct of hand disability and that totalling the scores of the brief MHQ does not provide a valid measure of hand disability for people with thumb osteoarthritis. The 37-item Michigan Hand Questionnaire may provide a better assessment of hand disability for patients with thumb osteoarthritis.
简短密歇根手问卷（brief MHQ）是一种 12 项自我报告的手部功能测量工具，适用于手部疾病患者，已通过经典测试理论进行验证。Rasch 分析可以提供更详细的心理计量学信息。本 Rasch 分析的目的是评估拇腕掌关节炎患者的 brief MHQ 的心理计量学特性，并在必要时提出改进问卷的建议。
从荷兰手部外科和治疗专门诊所接受治疗的 923 例拇腕掌关节炎患者中收集密歇根手问卷和人口统计学数据。使用 RUMM 2030 对 brief MHQ 的 12 个项目进行 Rasch 分析，以评估 brief MHQ 与 Rasch 模型的拟合程度。为了确定拟合度，评估了拟合摘要统计、个体拟合和个体项目拟合。评估阈值分布以确定是否需要重新评分任何项目。计算个体分离指数以衡量问卷的可靠性。评估差异项目功能以确定项目偏差，并进行主成分分析以确定单维性和局部依赖性。
brief MHQ 显示不拟合（χ=1312.5，p<0.0001），6 个项目的阈值存在紊乱，9 个项目需要重新评分。删除 3 个因项目拟合残差显著而需要重新评分的项目后，brief MHQ 的可靠性可接受（Cronbach's alpha=0.79）。模型不拟合（χ=49.6，p=0.0001）、多维性（10.2%的 t 检验结果显著）和 7 个项目的非均匀差异项目功能导致的项目偏差仍然存在于许多个体变量中。
尽管没有找到纠正与 Rasch 模型不拟合的满意解决方案，但建议重新评分 brief MHQ 的反应选项，并删除项目 6、9 和 10。非维度性表明项目不能代表手部残疾的单一结构，并且对 brief MHQ 的总分不能为拇腕掌关节炎患者提供手部残疾的有效测量。37 项密歇根手问卷可能为拇腕掌关节炎患者提供更好的手部残疾评估。
