Systematic review of the quality of the cross-cultural adaptations and validation of Michigan Hand Outcome Questionnaire (MHQ) and meta-analysis.

BACKGROUND

The Michigan Hand Questionnaire (MHQ) is a widely used patient-reported outcome measure (PROM) for assessing hand function. Cross-cultural adaptations are necessary to ensure its applicability and validity in diverse cultural contexts. However, the quality and psychometric properties of these adaptations remain unclear.

PURPOSE

This systematic review and meta-analysis aim to evaluate the psychometric properties, specifically reliability and content validity, of cross-cultural adaptations of the MHQ.

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

A systematic review following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines was conducted across four electronic databases, encompassing studies published between 1998 and 2024. Quality and content validity assessment was performed using the COSMIN methodology. Random effects meta-analysis was conducted for interclass correlation coefficient (ICC) and Cronbach's alpha.

RESULTS

Twenty-one studies were included. We identified two studies with high-quality evidence for content validity and ICC, and two studies demonstrating strong internal consistency. The MHQ demonstrated strong internal consistency (Cronbach's alpha: 0.73-0.99) and moderate to high test-retest reliability (ICC: 0.91-0.93). However, significant heterogeneity was observed in Cronbach's alpha and ICC values across domains, likely due to factors beyond test-retest duration. Meta-regression analysis revealed publication bias, possibly influenced by participant and study characteristics.

CONCLUSION

This meta-analysis supports the reliability of the MHQ for assessing hand function across cultures. However, variability in ICC values suggests a need for further investigation into factors influencing reliability. While the MHQ is a valuable tool, future research should address limitations in structural validity and explore cultural factors to enhance its cross-cultural applicability.