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Examiners' influence on the measured active and passive extension deficit in finger joints affected by Dupuytren disease

Nordenskjöld, Jesper LU ; Brodén, Stina and Atroshi, Isam LU (2018) In BMC Medical Research Methodology 18(1).
Abstract

Background: The most commonly reported outcome measure in Dupuytren disease is the extension deficit in finger joints. This study aimed to investigate the examiners' influence on the measured difference between active and passive extension deficit. Methods: A prospective cohort study was conducted on 157 consecutive patients (81% men, mean age 70 years) scheduled for collagenase treatment for Dupuytren disease. Before injection, one of three experienced hand therapists measured active extension deficit (AED) and passive extension deficit (PED) in the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the affected fingers using a hand-held metal goniometer. We included joints with ≥10° AED, and calculated mean AED and... (More)

Background: The most commonly reported outcome measure in Dupuytren disease is the extension deficit in finger joints. This study aimed to investigate the examiners' influence on the measured difference between active and passive extension deficit. Methods: A prospective cohort study was conducted on 157 consecutive patients (81% men, mean age 70 years) scheduled for collagenase treatment for Dupuytren disease. Before injection, one of three experienced hand therapists measured active extension deficit (AED) and passive extension deficit (PED) in the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the affected fingers using a hand-held metal goniometer. We included joints with ≥10° AED, and calculated mean AED and PED in MCP and PIP joints measured by each examiner. For adjusted analysis we used a mixed effects model to determine the relationship between the examiner and the AED-PED difference. Results: For all 291 joints measured, mean AED was 46° (SD 21) and mean PED was 37° (SD 23). Mean difference between AED and PED measured by examiner 1 was 6° (SD 6), by examiner 2 was 9° (SD 9), and by examiner 3 was 12° (SD 9). The mixed effects model analysis showed that the identity of the examining therapist was a significant determinant of the AED-PED difference. Conclusions: In Dupuytren disease measurement of active and passive extension deficit in finger joint contractures may vary significantly between different examiners. This must be taken into consideration when designing clinical studies and comparing outcomes between studies.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Dupuytren disease, Hand surgery, Outcome measures
in
BMC Medical Research Methodology
volume
18
issue
1
article number
120
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85055618569
  • pmid:30373511
ISSN
1471-2288
DOI
10.1186/s12874-018-0577-8
language
English
LU publication?
yes
id
55d5972b-5b63-47e1-af08-c2eb7ef25bcf
date added to LUP
2018-11-15 10:13:46
date last changed
2021-09-29 01:45:06
@article{55d5972b-5b63-47e1-af08-c2eb7ef25bcf,
  abstract     = {<p>Background: The most commonly reported outcome measure in Dupuytren disease is the extension deficit in finger joints. This study aimed to investigate the examiners' influence on the measured difference between active and passive extension deficit. Methods: A prospective cohort study was conducted on 157 consecutive patients (81% men, mean age 70 years) scheduled for collagenase treatment for Dupuytren disease. Before injection, one of three experienced hand therapists measured active extension deficit (AED) and passive extension deficit (PED) in the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the affected fingers using a hand-held metal goniometer. We included joints with ≥10° AED, and calculated mean AED and PED in MCP and PIP joints measured by each examiner. For adjusted analysis we used a mixed effects model to determine the relationship between the examiner and the AED-PED difference. Results: For all 291 joints measured, mean AED was 46° (SD 21) and mean PED was 37° (SD 23). Mean difference between AED and PED measured by examiner 1 was 6° (SD 6), by examiner 2 was 9° (SD 9), and by examiner 3 was 12° (SD 9). The mixed effects model analysis showed that the identity of the examining therapist was a significant determinant of the AED-PED difference. Conclusions: In Dupuytren disease measurement of active and passive extension deficit in finger joint contractures may vary significantly between different examiners. This must be taken into consideration when designing clinical studies and comparing outcomes between studies.</p>},
  author       = {Nordenskjöld, Jesper and Brodén, Stina and Atroshi, Isam},
  issn         = {1471-2288},
  language     = {eng},
  number       = {1},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Medical Research Methodology},
  title        = {Examiners' influence on the measured active and passive extension deficit in finger joints affected by Dupuytren disease},
  url          = {http://dx.doi.org/10.1186/s12874-018-0577-8},
  doi          = {10.1186/s12874-018-0577-8},
  volume       = {18},
  year         = {2018},
}