Validation of the Intermittent and Constant Osteoarthritis Pain Questionnaire in Patients with Hand Osteoarthritis: Results from the Nor-Hand Study.
OBJECTIVE
To examine the validity of a modified Intermittent and Constant Osteoarthritis Pain (ICOAP) questionnaire for assessment of pain in hand osteoarthritis (OA).


METHODS
The modified ICOAP-hand questionnaire was administered to 300 patients [89% female, median (interquartile range) age: 61 (57-66) yrs] in the Nor-Hand observational cohort study. The questionnaire was completed twice by 31 patients and test-retest reliability was assessed by intraclass correlation coefficients (ICC) for sum scores and weighted κ scores for individual items. Internal consistency was assessed by Cronbach's alpha coefficient and item-total correlations. Correlations between the ICOAP-hand questionnaire, the Australian/Canadian Hand OA Index (AUSCAN) hand pain subscale, and pain on a numerical rating scale (NRS) were analyzed using Spearman correlation analyses.


RESULTS
We found a substantial overlap between constant and intermittent pain (46% reporting constant + intermittent pain and 33% reporting no pain). Test-retest reliability analysis of ICOAP-hand showed an ICC of 0.89 for the total scale and weighted κ values between 0.39-0.70 for the individual items. Principal component analysis revealed one component with an eigenvalue of 7.9, explaining 72% of the total variance. Cronbach's alpha coefficient values > 0.93 and strong item-total correlations proved high internal consistency. ICOAP-hand was strongly correlated with NRS hand pain and the AUSCAN pain subscale.


CONCLUSION
ICOAP-hand is a reliable pain index that correlates with other available pain questionnaires. However, our results indicate that constant and intermittent pain do not represent separate constructs in hand OA, questioning the usefulness of the 2 subscales. [ClinicalTrials.gov: NCT03083548].
['Gløersen|Marthe|M|0000-0003-2233-4370', 'Steen Pettersen|Pernille|P|0000-0003-0312-4255', 'Kvien|Tore K|TK|', 'Haugen|Ida K|IK|0000-0001-7810-2216']
D000368:Aged D001315:Australia D004185:Disability Evaluation D005260:Female D050823:Hand Joints D006801:Humans D008297:Male D008875:Middle Aged D010003:Osteoarthritis D010147:Pain Measurement D015203:Reproducibility of Results D012720:Severity of Illness Index D011795:Surveys and Questionnaires
OSTEOARTHRITIS PAIN HAND OUTCOME ASSESSMENT