Core outcome measurement instrument selection for physical function in hand osteoarthritis using the OMERACT Filter 2.1 process

Féline P.B Kroon,Désirée Van Der Heijde,Lara J Maxwell,Dorcas E Beaton,Abishek Abishek,Francis Berenbaum,Francisco J Blanco,Philip G Conaghan,Krysia Dziedzic,Catherine L Hill,Ida K Haugen,Mariko Ishimori,Valentin Ritschl,Tanja A Stamm,Ruth Wittoek,Margreet Kloppenburg

doi:10.1016/j.semarthrit.2021.08.014

Abstract

ObjectivePhysical function is one of the Outcome Measures in Rheumatology (OMERACT) core outcome domains for hand osteoarthritis studies. Our aim was to select appropriate instrument(s) to measure this domain, as part of the development of a core outcome measurement set. MethodsFollowing the OMERACT Filter 2.1 instrument selection process, the (function subscale of) the Australian/Canadian Hand Osteoarthritis Index (AUSCAN), Functional Index for Hand Osteoarthritis (FIHOA) and Michigan Hand Outcomes Questionnaire (MHQ) were assessed for domain match, feasibility, truth and discrimination. Data gathered from available literature, working group and patient surveys, and additional analyses in two hand osteoarthritis cohorts were used to inform a consensus process. Results were summarized in Summary of Measurements Properties tables and reviewed by the OMERACT technical advisory group. ResultsMHQ passed the assessment of domain match and feasibility by the working group and patient research partners. For AUSCAN important limitations in feasibility were noted, but domain match was good. FIHOA did not pass the assessment and was not taken through the follow-up assessment. Based on published literature, reliability and construct/longitudinal validity of both MHQ and AUSCAN fulfilled OMERACT standards. While clinical trial discrimination and thresholds of meaning were good for AUSCAN, results for MHQ were ambiguous. ConclusionMHQ was provisionally endorsed as OMERACT core outcome measure for the core domain physical function. While AUSCAN may have better metric properties than MHQ, it received provisional endorsement as a second measure of function due to important feasibility issues. A research agenda to merit full endorsement was set.

Highlights

Physical function is an important outcome domain to evaluate in patients with hand osteoarthritis (OA) as it is often impaired, impacts daily living and reduces quality of life [1,2]
Michigan Hand Outcomes Questionnaire (MHQ) was provisionally endorsed as OMERACT core outcome measure for the core domain physical function
A comparison of the aspects of the three instruments and the working group’s assessment of domain match and feasibility of Australian/Canadian Hand Osteoarthritis Index (AUSCAN), FIHOA and MHQ was previously published in a report of the hand OA working group Special Interest Group (SIG) at OMERACT 2018 [8]

Summary

Introduction

Physical function is an important outcome domain to evaluate in patients with hand osteoarthritis (OA) as it is often impaired, impacts daily living and reduces quality of life [1,2]. In 2014, the Outcome Measures in Rheumatology (OMERACT) Hand OA Working Group endorsed a core domain set for clinical trials of symptom and structure modification and observational studies [4]. It includes six domains for all settings (pain, physical function, patient global assessment, health-related quality of life, joint activity, and hand strength), and two additional domains for trials of structure modification and observational studies (hand mobility, structural damage). A preliminary core instrument set was proposed, based on available literature at the time. We report the final instrument selection for the first OMERACT hand OA core domain: physical function

Methods

Results

Conclusion