Journal of Hand Therapy 28 (2015) 336

Contents lists available at ScienceDirect

Journal of Hand Therapy journal homepage: www.jhandtherapy.org

Letter to the Editor

Why do we need new patient-reported outcomes? The last decades have seen a proliferation of patient-reported outcomes (PROs) in rehabilitation. The upper extremity has not been left out of this trend. In fact, several types of PROs are available for the upper extremity. They include general upper extremityquestionnaires, such as the Disability of the Arm, Shoulder and Hand (DASH) questionnaire and the Upper Limb Functional Index (ULFI), joint-specific questionnaires like the Patient-Rated Wrist Evaluation, and condition-specific questionnaires such as the Boston Carpal Tunnel Symptom Severity Scale (BCTQ). This proliferation of PROs for the upper extremity has impeded research by making comparisons between studies challenging. Publications on established PROs also include a wealth of comparative data that can increase their value for clinical use. In cases where PROs with sound psychometric properties are already available, before contemplating the development of a new PRO or the translation/adaptation of an existing PRO, one must wonder if such an undertaking is necessary for researchers and health professionals. Researchers or health professionals tend to amplify the limitations of existing measures.1 Some of them probably underestimate the energy needed to develop an adequate new PRO or translate/adapt an existing one. Therefore, a useful first step before developing or translating a PRO is to review the existing ones to determine if one might suit the clinical or research needs. A new PRO should be developed for constructs for which there are no measures yet, and not for ones that are already assessed with well-validated and accepted tools. Other reasons for developing a new PRO might include the need for a PRO that is faster to complete by the patients or easier to administer by the health professionals. The same rationale should be used for translations/ adaptations. Looking at the study by Tonga et al (Cross-cultural adaptation, reliability and validity of the Turkish version of the ULFI),2 one can wonder why the ULFI is necessary for health professionals in Turkey given that the DASH and the QuickDASH, which evaluate similar constructs as the ULFI, are already available in Turkish. In fact, the

Turkish versions of the DASH and QuickDASH have been shown to have sound psychometric properties and are well accepted by the health professionals.3,4 What will the ULFI bring to those health professionals? Tonga et al justified their choice of translating the ULFI in Turkish by short implementation time, simple scoring and readability levels. Although their justifications could be debated, only time will tell if the ULFI will be accepted by the health professionals and researchers in Turkey.

References 1. Streiner DL, Norman GR. Health Measurement Scales: A Practical Guide to Their Development and Use. 3rd ed. Oxford: Oxford University Press; 1995. 2. Tonga E, Durutürk N, Gabel P, Tekindal A. Cross-cultural adaptation, reliability and validity of the Turkish version of the Upper Limb Functional Index (ULFI). J Hand Ther; 2014. http://dx.doi.org/10.1016/j.jht.2014.11.001. 3. Düger T, Yakut E, Öksüz Ç, et al. Kol, Omuz ve El Sorunları (Disabilities of the i ve Arm, Shoulder and Hand e DASH) Anketi Türkçe uyarlamasının güvenirlig i. Fizyoter Rehabil. 2006;17(3):99e107. geçerlig 4. Kitis A, Celik E, Aslan U, Zencir M. DASH questionnaire for the analysis of musculoskeletal symptoms in industry workers: a validity and reliability study. Appl Ergon. 2009;40(2):251e255.

0894-1130/$ e see front matter Ó 2015 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jht.2015.01.010

Jean-Sébastien Roy, PT, PhD Center for Interdisciplinary Research in Rehabilitation and Social Integration Quebec City Quebec Canada Department of Rehabilitation Faculty of Medicine Université Laval Quebec City Quebec Canada Tel.: þ1 418 529 9141x6005; fax: þ1 418 529 3548. E-mail address: [email protected]

Why do we need new patient-reported outcomes?

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