Evaluation of the measurement properties of 10 measurement instruments specifically assessing functional outcome after distal radius fracture: a systematic review

Objectives: The primary aim of this study was to systematically review the methodological quality of studies on the measurement properties of functional outcome instruments in the evaluation of patients with distal radius fractures. The secondary aim of this study was to advise which functional outcome instrument is most suitable, based on the found methodological quality and measurement properties. Methods: A systematic literature search was performed in Pubmed, Embase, Cinahl and Psycinfo databases to identify relevant studies. Two reviewers independently screened and rated the quality of the studies on their measurement properties, according to the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. Results: A total of 14 out of 868 unique studies were included, in which 10 measurement instruments were rated; 9 self-administered questionnaires and 1 hand function test. In general, the methodological quality of the studies was fair. The best scored the Patient-Rated Wrist Evaluation (PRWE) and the Disabilities of Arm, Neck and Shoulder questionnaire (DASH). The worst scored the Patient Evaluation Measure, the Arthritis Impact Measurement Scale and the Brigham and Women’s Hospital carpal tunnel questionnaire. The PRWE scored good on content validity, hypotheses testing and cross-cultural validity, fair on reliability and responsiveness and poor on internal consistency and interpretability. The DASH scored good on internal consistency, reliability and hypotheses testing and responsiveness was rated fair. Other instruments, such as the Michigan Hand Questionnaire and the Short Form-36 were rated fair or even poor. Conclusion: The PRWE and DASH scored best on methodological quality. Other measurement instruments on functional outcome in patients with DRF than the PRWE and DASH are not recommended at this moment. Nevertheless, the measurement properties of the PRWE and DASH need further research, which preferable should score excellent on all items used on the COSMIN-checklist.