Validation of an algofunctional index for XXXX of the hand.

@entity1 @entity2270 @entity571 @entity158
Although @entity571 is common, it has been the focus of few therapeutic trials. In addition to the problems raised by clinical trials in @entity571 in general and to the difficulties due to the unforeseeable course of @entity571 of the trapezometacarpal and finger joints, the lack of a clinical tool for assessing @entity158 and function over time is an additional obstacle. We propose an algofunctional index designed for evaluation and symptomatic follow-up of @entity1 with @entity571 . The index is based on a physician-administered questionnaire on 10 daily activities involving the hands. The @entity1 is asked to answer each item using a 4-point verbal scale, from "possible without difficulty" (0) to "impossible" (3 points); thus, total scores range from 0 to 30. This index has been used in a few clinical placebo-controlled trials and was found sensitive to change. The aim of this study was to assess the metrological qualities of this index, including consistency (internal and external), sensitivity and specificity (by scoring the index in different groups of subjects), intra-observer reproducibility, and ease of use. Three hundred @entity1 were recruited by 25 rheumatologists: 100 had a @entity158 (mean age: 64.9 years) with a score of more than 40 mm on a visual analog scale for overall @entity158 severity (mean: 57.3 +/- 14 mm), 100 had "inactive" @entity571 (mean age 67.0 years), and 100 had no diseases of the upper limbs. Specificity/sensitivity: the mean index score was 12.41 +/- 5.41 in @entity1 with painful @entity571 , 4.28 +/- 3.87 in "inactive" cases, and 0.59 +/- 1.23 in controls. External consistency: the overall mean score was well correlated with @entity158 severity: r = 0.49 (p < 0.001). Internal consistency: principal component analysis identified a primary @entity2270 responsible for 44.2% of the variance and two secondary axes each responsible for slightly more than 9% of the variance. None of the questions seemed redundant. Intra-observer reproducibility: two evaluations done one hour apart in symptomatic @entity1 yielded the following scores: 12.32 +/- 5.41 and 12.5 +/- 5.51 (correlation: 0.95; mean difference: 0.17 +/- 1.64; coefficient of variation: 9.32%). Kappa values for both measurements of each item ranged from 0.68 to 0.87. Ease of use: mean time needed to determine the score 2.5 +/- 2 min. The scoring process was considered simple by 100% of investigators and easy/very easy by 98% of @entity1 .(ABSTRACT TRUNCATED AT 400 WORDS)
