Ab0834 validity and psychometric characteristics of the duruöz hand index in turkish patients with systemic sclerosis

Background The Duruöz Hand Index (DHI) is a self-report questionnaire that was developed for evaluating the functional status of hands in patients with rheumatoid arthritis and subsequently validated in many cultures and various rheumatic patient groups [1]. Objectives The aim of the study was to investigate the validity and psychometric properties of DHI in patients with systemic sclerosis (SSc). Methods Patients diagnosed with SSc according to the EULAR/ACR 2013 system were included [2]. Demographic and clinical characteristics of the patients were recorded. Functional assessments of the hands were evaluated with DHI, Keitel Functional Index (KFI), visual analog scale (VAS) for disability, VAS-Handicap for handicap, and Health Assessment Questionnaire (HAQ). Short Form-36 (SF36) was used for assessing quality of life. Disease activity was assessed with European Scleroderma Study Group (EScSG) activity index and VAS doctor’s opinion for activity. Modified Rodnan skin score (mRSS), VAS-Hand pain, VAS-Raynoud, swollen joint count (SJC), tender joint count (TJC), Pittsburgh sleep quality index (PSQI), and CRP levels were also noted. For the reliability analysis, internal consistency (Cronbach’s alpha) and test-retest reliability (ICC); and for the validity analysis face, content, convergent, and divergent validities were applied. Face and content validities were evaluated via cognitive debriefing interviews with the patients. The correlations of the DHI with KFI, VAS-disability, VAS-Handicap, and HAQ were analyzed for convergent validity. The correlations of the DHI with other measurements (non-functional) were analyzed for divergent validity. Results Seventy-three patients with a mean age of 48.6 (SD 12.8) years were recruited and 57 of them were women. Cognitive debriefing showed the DHI to be clear, understandable, and relevant. It was easy to complete and calculate, with the 5 minutes and 30 seconds, respectively. The Cronbach’s alpha coefficient for internal consistency was 0.973 and ICC for test-retest reliability was 0.993 (95%CI 0.981-0.997). DHI showed good to moderate correlations with the functional measurements indicating its convergent validity and moderate to non-significant correlations with the non-functional parameters supporting its divergent validity (Table 1). Conclusion DHI is a quite practical, reliable, and valid instrument to assess hand function in patients with SSc. References [1]Duruöz MT et al. Development and validation of a rheumatoid hand functional disability scale that assess functional handicap. J Rheumatol 1996; 23:1167-72. [2]van den Hoogen F et al. 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Ann Rheum Dis. 2013;72(11):1747-1755. Table 1. Spearman’s correlation coefficients of Duruöz Hand Index with the other parameters for convergent and divergent validity Functional Parameters (Convergent) Rho Non-functional Parameters (Divergent) Rho KFI 0.970 ** Age -0.124 VAS-Disability 0.524 ** Disease duration 0.347 * VAS-Handicap 0.567 ** CRP 0.246 * HAQ 0.395 * SJC 0.273 * TJC 0.464 ** mRSS 0.495 ** EScSG 0.535 ** VAS-raynoud 0.419 ** VAS-Hand pain 0.512 ** VAS-Doctor’s activity opinion 0.484 ** SF36 Physical functioning -0.338 * SF36 Physical role limitations -0.525 ** SF36 Emotional role limitations -0.375 * SF36 Vitality -0.164 SF36 Emotional well-being -0.085 SF36 Social functioning -0.336 * SF36 Pain -0.259 * PSQI 0.305 * ** p<0.001, *p: 0.001-0.049. Acknowledgements: NIL. Disclosure of Interests None Declared.