Abstract
BackgroundThe Musculoskeletal Health Questionnaire (MSK-HQ) has been developed to measure musculoskeletal health status across musculoskeletal conditions and settings. However, the MSK-HQ needs to be further evaluated across settings and different languages.ObjectiveThe objective of the study was to evaluate and compare measurement properties of the MSK-HQ across Danish (DK) and English (UK) cohorts of patients from primary care physiotherapy services with musculoskeletal pain.MethodsMSK-HQ was translated into Danish according to international guidelines. Measurement invariance was assessed by differential item functioning (DIF) analyses. Test-retest reliability, measurement error, responsiveness and minimal clinically important change (MCIC) were evaluated and compared between DK (n = 153) and UK (n = 166) cohorts.ResultsThe Danish version demonstrated acceptable face and construct validity. Out of the 14 MSK-HQ items, three items showed DIF for language (pain/stiffness at night, understanding condition and confidence in managing symptoms) and three items showed DIF for pain location (walking, washing/dressing and physical activity levels). Intraclass Correlation Coefficients for test-retest were 0.86 (95% CI 0.81 to 0.91) for DK cohort and 0.77 (95% CI 0.49 to 0.90) for the UK cohort. The systematic measurement error was 1.6 and 3.9 points for the DK and UK cohorts respectively, with random measurement error being 8.6 and 9.9 points. Receiver operating characteristic (ROC) curves of the change scores against patients’ own judgment at 12 weeks exceeded 0.70 in both cohorts. Absolute and relative MCIC estimates were 8–10 points and 26% for the DK cohort and 6–8 points and 29% for the UK cohort.ConclusionsThe measurement properties of MSK-HQ were acceptable across countries, but seem more suited for group than individual level evaluation. Researchers and clinicians should be aware that some discrepancy exits and should take the observed measurement error into account when evaluating change in scores over time.
Highlights
The Musculoskeletal Health Questionnaire (MSK-HQ) has been developed to measure musculoskeletal health status across musculoskeletal conditions and settings
The two different constructs; pain and stiffness used in item 1 and item 2 led to some discussion in the project group, as well as the different constructs in item ‘understanding condition’ and item ‘confidence in managing’
Cognitive debriefing interviews with pilot patients with various musculoskeletal disorders revealed no difficulties with respect to the above-mentioned concerns
Summary
The Musculoskeletal Health Questionnaire (MSK-HQ) has been developed to measure musculoskeletal health status across musculoskeletal conditions and settings. Patient reported outcomes measures (PROMs) are increasingly used to support the assessment, treatment and monitoring of persons with musculoskeletal disorders [6]. A wide range of questionnaires for musculoskeletal disorders have been developed. These questionnaires are typically limited to specific parts of the body, e.g. pain in the shoulder and arm [7], neck and back [8, 9], hip and knee [10]. Some only cover a small number of health-related domains (e.g. pain and function) [13], and thereby may not be sensitive to the multidimensionality of treatment targets inherent in managing musculoskeletal disorders
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