Background In clinical practice we have observed that patients with hand OA frequently have severe pain, stiffness and physical disability. A new disease specific measure of hand OA has been developed, termed the Australian/Canadian (AUSCAN) osteoarthritis hand index.
Objectives To make preliminary investigations of the performance of the Norwegian version of AUSCAN by examining correlations between scores of AUSCAN and other generic and disease specific health status measures.
Methods The AUSCAN is a disease specific health status measure for hand OA measuring pain (5 items), stiffness (1 item) and difficulties with daily activities (9 items). The instrument was translated to Norwegian according to standardised procedures. Fifty-one patients between 50 and 70 years of age with hand OA (mean (SD) age 66.1 (4.4) years, 4(8%) males) underwent a comprehensive clinical examination including completion of several self-reported health status questionnaires. Among these were AUSCAN, AIMS2, SF-36, MHAQ, pain and fatigue on VAS. All patients had previously been referred to a rheumatology outpatient department. Internal validity was examined by Cronbach alpha, correlations with other scales by Pearson correlation coefficients. Our pre-study hypothesis was to confirm AUSCAN as a specific hand measure with strong or substantial correlations (r > 0.50) to hand measures of similar dimensionality, and lower correlations between the AUSCAN measures and generalised measures within the same dimension of health, and low correlations between AUSCAN scales and measures capturing different dimensions.
Results The internal validity of the AUSCAN scales was satisfactory (Cronbach alpha 0.95 and 0.93 for AUSCAN physical and pain, respectively). Correlations between AUSCAN physical and stiffness/pain were 0.67/0.85, between pain and stiffness 0.67. The correlation between the physical scale/pain scale/stiffness scales of AUSCAN with AIMS2 hand and finger function was 0.70/0.54/0.33 respectively, with grip strength ?0.55/-0.42/-0.22, MHAQ 0.49/0.37/0.39, AIMS2 physical 0.52/0.44/0.26, SF-36 physical ?0.27/-0.23/-0.10, WOMAC physical 0.37/0.43/0.33, WOMAC stiffness 0.20/0.27/0.27, WOMAC pain 0.27/0.40/0.28, pain VAS 0.31/0.45/0.33, AIMS2 pain 0.47/0.59/0.45, SF-36 pain ?0.37/-0.42/-0.24, fatigue VAS 0.34/0.37/0.11, AIMS2 affect 0.32/0.36/0.04, and with SF-36 mental ?0.14/-0.13/0.17, for the physical/pain/stiffness scales of AUSCAN, respectively.
Conclusion In general, our pre-study hypothesis was supported by the results. The physical dimension of AUSCAN appeared to be strongly or substantially correlated to other measures of hand function, and moderately correlated to other measures of physical disability. The pain measure was moderately correlated to other pain measures, whereas the correlation between the stiffness dimension of AUSCAN and WOMAC was rather low (0.27). These preliminary data indicate that the Norwegian version of AUSCAN is appropriate for use in patients with hand OA.
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