Subscribe to RSS
Development and Validation of a Survey to Measure Patients' Expectations of Wrist Arthritis SurgeryFunding Hospital for Special Surgery Surgeon-In-Chief Fund 2015.
Background The purpose of this study was to develop and test a patient-derived expectations survey for wrist arthritis surgery. We hypothesized that preoperative patient expectations are higher in people with greater functional impairment and that postoperative fulfilment of patient expectations correlates with functional improvement.
Methods The study was conducted in four phases.
Development (n = 22) Preoperatively, patients were asked open-ended questions regarding expectations of surgery. A draft survey was then assembled.
Reliability (n = 35) The survey was administered twice preoperatively. Concordance was measured with weighted kappa values and intraclass correlations (ICC).
Validity (n = 58) Validity was assessed by comparing responses from the Expectations Survey to the patient-rated wrist evaluation (PRWE).
Responsiveness (n = 18) Responsiveness was calculated by comparing the proportion of expectations fulfilled to PRWE scores 1-year postoperatively.
Results Development Twenty-two distinct items representing the most frequent responses were utilized from the draft survey items of 1,244 expectations volunteered.
Reliability Patients had high preoperative expectations of surgery (mean = 76.8); 30% had scores ≥90. Test–retest reliability was high (Cronbach α coefficients = 0.91, 0.93, ICC = 0.86). Endorsement of items = 66 to 100%; and weighted kappa values = 0.39 to 0.96.
Validity Patients with greater preoperative expectations (≥63) had more pain, worse function, and worse PRWE scores than those with lower expectations.
Responsiveness The proportion of fulfilled expectations was high (mean 0.80, median 0.79), and greater fulfillment (proportion > 0.80, n = 8) was associated with better postoperative PRWE scores.
Conclusion The patient-derived expectations survey is reliable, valid, responsive, and addresses a spectrum of expectations for patients undergoing surgery for wrist arthritis.
Clinical relevance Understanding patient expectations can contribute to customized care given the range of surgical choices for the arthritic wrist.
Research Institution: Hospital for Special Surgery
Received: 08 July 2022
Accepted: 12 October 2022
Article published online:
08 December 2022
© 2022. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
- 1 Andersson JK, Hagert E, Brittberg M. Cartilage injuries and posttraumatic osteoarthritis in the wrist: a review. Cartilage 2021; 13 (1_suppl): 156S-168S
- 2 Laulan J, Marteau E, Bacle G. Wrist osteoarthritis. Orthop Traumatol Surg Res 2015; 101 (suppl 1): S1-S9
- 3 Kurdi AJ, Voss BA, Tzeng TH, Scaife SL, El-Othmani MM, Saleh KJ. Rheumatoid arthritis vs osteoarthritis: comparison of demographics and trends of joint replacement data from the nationwide inpatient sample. Am J Orthop 2018;47(07):
- 4 Akhondi H, Panginikkod S. Wrist Arthritis. . In: StatPearls. . StatPearls Publishing; 2020. Accessed July 11, 2020
- 5 Shah CM, Stern PJ. Scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrist arthritis. Curr Rev Musculoskelet Med 2013; 6 (01) 9-17
- 6 Hoang-Kim A, Pegreffi F, Moroni A, Ladd A. Measuring wrist and hand function: common scales and checklists. Injury 2011; 42 (03) 253-258
- 7 Laulan J, Bacle G, de Bodman C. et al. The arthritic wrist. II–the degenerative wrist: indications for different surgical treatments. Orthop Traumatol Surg Res 2011; 97 (suppl 4): S37-S41
- 8 Le Nen D, Richou J, Simon E. et al. The arthritic wrist. I—the degenerative wrist: surgical treatment approaches. Orthop Traumatol Surg Res 2011; 97 (suppl 4): S31-S36
- 9 Rainbow MJ, Wolff AL, Crisco JJ, Wolfe SW. Functional kinematics of the wrist. J Hand Surg Eur Vol 2016; 41 (01) 7-21
- 10 Singh HP, Brinkhorst ME, Dias JJ, Moojen T, Hovius S, Bhowal B. Dynamic assessment of wrist after proximal row carpectomy and 4-corner fusion. J Hand Surg Am 2014; 39 (12) 2424-2433
- 11 Singh HP, Bhattacharjee D, Dias JJ, Trail I. Dynamic assessment of the wrist after total wrist arthroplasty. J Hand Surg Eur Vol 2017; 42 (06) 573-579
- 12 Wolff AL, Garg R, Kraszewski AP. et al. Surgical treatments for scapholunate advanced collapse wrist: kinematics and functional performance. J Hand Surg Am 2015; 40 (08) 1547-1553
- 13 Bain GI, McGuire DT. Decision making for partial carpal fusions. J Wrist Surg 2012; 1 (02) 103-114
- 14 Slutsky DJ. Outcomes assessment in wrist surgery. J Wrist Surg 2013; 2 (01) 1-4
- 15 Changulani M, Okonkwo U, Keswani T, Kalairajah Y. Outcome evaluation measures for wrist and hand: which one to choose?. Int Orthop 2008; 32 (01) 1-6
- 16 Karnezis IA, Fragkiadakis EG. Association between objective clinical variables and patient-rated disability of the wrist. J Bone Joint Surg Br 2002; 84 (07) 967-970
- 17 Mehta SP, MacDermid JC, Richardson J, MacIntyre NJ, Grewal R. A systematic review of the measurement properties of the patient-rated wrist evaluation. J Orthop Sports Phys Ther 2015; 45 (04) 289-298
- 18 Dacombe PJ, Amirfeyz R, Davis T. Patient-reported outcome measures for hand and wrist trauma: is there sufficient evidence of reliability, validity, and responsiveness?. Hand (N Y) 2016; 11 (01) 11-21
- 19 Kleinlugtenbelt YV, Krol RG, Bhandari M, Goslings JC, Poolman RW, Scholtes VAB. Are the patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and hand (DASH) questionnaire used in distal radial fractures truly valid and reliable?. Bone Joint Res 2018; 7 (01) 36-45
- 20 Wolff AL, Patel Y, Zusstone E, Wolfe SW. Self-identified functional limitations improve in patients with degenerative wrist arthritis after surgery. J Hand Ther 2020; 33 (04) 540-546
- 21 Sagerfors M, Gupta A, Brus O, Rizzo M, Pettersson K. Patient related functional outcome after total wrist arthroplasty: a single center study of 206 cases. Hand Surg 2015; 20 (01) 81-87
- 22 Hoogendam L, Koopman JE, van Kooij YE. et al; and the Hand-Wrist Study Group. What are the minimally important changes of four commonly used patient-reported outcome measures for 36 hand and wrist condition-treatment combinations?. Clin Orthop Relat Res 2022; 480 (06) 1152-1166
- 23 De Ridder WA, Wouters RM, Hoogendam L, Vermeulen GM, Slijper HP, Selles RW. Hand-Wrist Study Group. Which factors are associated with satisfaction with treatment results in patients with hand and wrist conditions? A large cohort analysis. Clin Orthop Relat Res 2022; 480 (07) 1287-1301
- 24 Mancuso CA, Salvati EA, Johanson NA, Peterson MG, Charlson ME. Patients' expectations and satisfaction with total hip arthroplasty. J Arthroplasty 1997; 12 (04) 387-396
- 25 Mancuso CA, Sculco TP, Wickiewicz TL. et al. Patients' expectations of knee surgery. J Bone Joint Surg Am 2001; 83 (07) 1005-1012
- 26 Mancuso CA, Duculan R, Stal M, Girardi FP. Patients' expectations of lumbar spine surgery. Eur Spine J 2015; 24 (11) 2362-2369
- 27 Mancuso CA, Duculan R, Cammisa FP. et al. Proportion of expectations fulfilled: a new method to report patient-centered outcomes of spine surgery. Spine 2016; 41 (11) 963-970
- 28 Mancuso CA, Cammisa FP, Sama AA, Hughes AP, Ghomrawi HMK, Girardi FP. Development and testing of an expectations survey for patients undergoing lumbar spine surgery. J Bone Joint Surg Am 2013; 95 (19) 1793-1800
- 29 Mancuso CA, Ranawat AS, Meftah M, Koob TW, Ranawat CS. Properties of the patient administered questionnaires: new scales measuring physical and psychological symptoms of hip and knee disorders. J Arthroplasty 2012; 27 (04) 575-582.e6
- 30 Mancuso CA, Duculan R, Stal M, Girardi FP. Patients' expectations of cervical spine surgery. Spine 2014; 39 (14) 1157-1162
- 31 Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res 2016; 26 (13) 1753-1760
- 32 Berkwits M, Inui TS. Making use of qualitative research techniques. J Gen Intern Med 1998; 13 (03) 195-199
- 33 Kramer MS, Feinstein AR. Clinical biostatistics. LIV. The biostatistics of concordance. Clin Pharmacol Ther 1981; 29 (01) 111-123
- 34 Donner A, Eliasziw M. Sample size requirements for reliability studies. Stat Med 1987; 6 (04) 441-448
- 35 Mellstrand Navarro C, Ponzer S, Törnkvist H, Ahrengart L, Bergström G. Measuring outcome after wrist injury: translation and validation of the Swedish version of the patient-rated wrist evaluation (PRWE-Swe). BMC Musculoskelet Disord 2011; 12: 171
- 36 Mancuso CA, Lee SK, Saltzman EB. et al. Development of a questionnaire to measure impact and outcomes of brachial plexus injury. J Bone Joint Surg Am 2018; 100 (03) e14
- 37 Henn III RF, Ghomrawi H, Rutledge JR, Mazumdar M, Mancuso CA, Marx RG. Preoperative patient expectations of total shoulder arthroplasty. J Bone Joint Surg Am 2011; 93 (22) 2110-2115
- 38 Mancuso CA, Sculco TP, Salvati EA. Patients with poor preoperative functional status have high expectations of total hip arthroplasty. J Arthroplasty 2003; 18 (07) 872-878