Validity and factor structure of the AUSCAN Osteoarthritis Hand Index in a community-based sample1

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Summary

Objective

The AUStralian CANadian Osteoarthritis Hand Index (AUSCAN) is a self-report assessment of hand pain, stiffness, and function. Prior studies have examined its validity in small clinical samples and family-based samples. This study examined measurement properties of the AUSCAN in a large, community-based sample, extending knowledge about the scale's generalizability.

Methods

Participants (N = 1730, mean age = 61 years, 65% female, 30% African American) were enrolled in the Johnston County Osteoarthritis Project. We examined the internal consistency, construct validity, and factor structure of the AUSCAN among the total sample, as well as in subgroups according to gender, race, presence of hand pain, and presence of radiographic hand osteoarthritis (OA).

Results

Internal consistency was high for the total scale and subscales among the full study sample and all subgroups (Cronbach's alphas = 0.89–0.96). Construct validity was also supported, as grip and pinch strength were more strongly correlated with the AUSCAN function subscale than with the pain and stiffness subscales. Factor analysis showed that for the full sample and most subgroups, all pain items loaded on one factor (standardized regression coefficients 0.59–0.81) and all function items loaded on another (standardized regression coefficients 0.61–0.78), supporting the intended subscale structure of the scale. However, for African Americans, a different factor pattern emerged, with three function items loading on a factor with the pain items.

Conclusions

Results support the validity of the AUSCAN in a general sample of adults, as well as across demographic and clinical subgroups, although the subscale structures differed slightly by race.

Key words

Osteoarthritis
Hand
AUSCAN
Validity

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1

Centers for Disease Control and Prevention/Association of Schools of Public Health cooperative agreements S1734 and S3486 (JMJ, JBR), the NIAMS Multipurpose Arthritis and Musculoskeletal Disease Center grant 5-P60-AR30701 (JMJ, JBR, RDeV), and the NIAMS Multidisciplinary Clinical Research Center grant 5 P60 AR49465-03 (JMJ, JBR, RDeV).