Measuring quality of life and patient satisfaction in hand conditions

Abstract

**Background**: Patient reported outcomes are important for the assessment of the effectiveness of surgical interventions. If patient reported outcome measures are used to prioritise resources, then it is important to ensure that the instruments are scientifically valid. This review aims to assess whether the currently available patient reported outcome measures in hand surgery adhere to international development guidelines and whether they incorporate the use of item response theory or Rasch Analysis. **Methods**: A systematic review was performed to identify all patient reported outcome measures that are relevant to the field of hand surgery. An a priori protocol with strict inclusion and exclusion criteria was followed. Only instruments developed in the English language were included. A comprehensive search of nine databases was undertaken. The development methodology of the identified instruments was then analysed, followed by examination of the domain content and initial psychometric validation of each instrument. **Results**: A total of 3,039 article citations were retrieved, 139 citations went on to a full text review. A total of 24 patient reported outcome instruments were identified. This consisted of 10 regional upper limbs, six hand and/or wrist specific and a further eight condition specific instruments. Documentation of the details of patient reported outcome measure development was lacking for many instruments. **Conclusion**: The field of hand surgery has many instruments available, but few fulfil international development guidelines or use item response theory or Rasch Analysis psychometric techniques. There are limitations in either the breadth of the domains explored, or the developmental methodology used in all currently available instruments.