Evaluation of Hand Function in Rheumatic Disease. Validation and Usefulness of the Spanish Version AUSCAN, m-SACRAH, and Cochin Questionnaires

Abstract

IntroductionQuestionnaires to evaluate hand function are variable in the number of items, domains and diseases in which they had been previously used. Objectivesa) To translate to Spanish and validate the Modified Score for the Assessment and Quantification of Chronic Rheumatic Affection of the Hands (m-SACRAH), and Australian/Canadian Osteoarthritis Hand Index (AUSCAN) questionnaires; b) to do a transcultural adaptation of DASHe, previously validated in Spain); and c) to compare them and the Cochin questionnaire (previously validated in México), in rheumatic patients with variable impairment of hand function. Material and methodsm-SACRAH, AUSCAN, and Disabilities of the Arm, Shoulder and Hand (DASH) were translated/retro-translated and adapted. The final version was revised to determine content validity of m-SACRAH, AUSCAN, and DASH, plus Cochin were applied to 10 healthy subjects (pilot study) with a variable educational level and in 16 rheumatic patients with variable diagnoses and degrees of hand function impairment; all patients answered 4 questionnaires and were evaluated clinically by blinded investigators. ResultsSeventy-six percent were women, mean age 45.7±11.4 years. Cronbach's alpha >0.90; time to answer went from 2.3±0.087 (AUSCAN) to 3.5±0.36min (DASH). There was good correlation among them (r=0.0683 AUSCAN-m-SACRAH to r=0.889 AUSCAN–DASH) and good capability for discrimination between patients with mild vs moderate to severe impairment was also demonstrated; patients with mild impairment needed less time to answer them and there were no significant differences among questionnaire scores. Patients preferred AUSCAN (10/16), Cochin (4/16), and m-SACRAH (2/16). ConclusionThe 4 questionnaires are useful to evaluate hand function in rheumatic patients and have good discrimination capability. More patients preferred AUSCAN.