The Single Assessment Numeric Evaluation (SANE), PROMIS-UE, and QuickDASH for Elective Hand Surgeries

Abstract

Abstract Title: The Single Assessment Numeric Evaluation (SANE), PROMIS-UE, & QuickDASH for Elective Hand Surgeries Background: Validated patient-reported outcome measures provide important insight into condition-specific clinical outcomes, but they place a considerable time burden on patients, clinicians, and other staff. In response, efforts have been made to validate single-question surveys, such as the Single Assessment Numeric Evaluation (SANE) score, across orthopedic conditions, but few prospective studies have evaluated the SANE questionnaire for hand conditions specifically. Therefore, the purpose of this study was to validate the use of the SANE score in patients undergoing routine elective hand surgeries. We hypothesized that SANE scores would positively correlate with two other validated upper extremity surveys, PROMIS-UE and Quick-DASH. Methods: Patients scheduled to undergo carpal tunnel release and trigger finger release surgery completed three surveys (SANE, the Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS-UE) item bank, and the shortened Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire) preoperatively and at two postoperative time points (2-4 weeks postop and >90 days postop). Based on an a priori power calculation and values from previous studies, a minimum sample of 82 patients was needed to achieve 80% power to detect a change after treatment or intervention of the minimal clinically important difference (MCID) or greater on the QuickDASH with a 2-sided level of significance of .025. Results: A total of 89 patients completed all three timepoints. There were strong positive correlations between the changes in QuickDASH scores and the changes in PROMIS-UE scores between all three timepoints, which we expected since these surveys served as our controls. There was also a strong positive correlation between the changes in the SANE scores and the changes in QuickDASH scores when comparing early post-op to late post-op (Pearson coefficient 0.529187631, p-value <0.0001). All other timepoint comparisons had a moderate positive correlation between SANE and the validated surveys. Conclusion: One possible explanation as to why most of our correlations were moderate rather than strong is because of the difference in scaling. SANE’s 0%-100% scale allowed for a much larger percent change than the other two surveys’ (SANE's percent change range was 0-2900%, whereas QuickDASH's was 0-115.8% and PROMIS-UE's was 0-154.2%). Future studies are recommended to determine if changing the SANE scale to 1-10 would remedy this and lead to stronger correlations. With this in mind, our data still suggest that SANE can successfully evaluate elective hand surgery outcomes in the early and late postoperative periods.