Changes in Single Assessment Numeric Evaluation Over Time in Hand Surgery
Beau McGinley, MBA, Erica Smearman, MD PhD, Daniel Whittingslow, PhD, Oluwakorede Omole, BS, Kevin Cuneo, BS, Alex Dawes, BS, John T Hurt, BS, Angel Xiao, MS, Eric R Wagner, MD MScR and Michael B Gottschalk, MD, Emory University School Medicine, Atlanta, GA
Intro: Current patient reported outcome measure instruments are long and can be difficult to interpret. The purpose of this study is to assess the validity and responsiveness of the Single Assessment Numeric Evaluation (SANE) longitudinally over one year following seven common hand surgeries.
Methods: The SANE was compared to two previously validated patient reported outcome measures (PROMs), the quickDASH and PROMIS Pain Interference T score (PROMIS).
QuickDASH and PROMIS scores were collected on patients who underwent any of the following procedures: thumb carpometacarpal (CMC) arthroplasty, carpal tunnel release, cubital tunnel release, De Quervain's tendon release, distal radius fixation, Dupuytren's release, or trigger finger release. Validity, assessed by nonparametric Spearman rank-order correlation coefficients, and Responsiveness, assessed by Cohen's d Effect size and Wilcoxon Rank Sum tests, were calculated at preop, one month, three month, and six month time points. Responsiveness measures were calculated for the entire combined cohort, and individual groups of patients.
Results: 709 patients were included for analysis. Approximately 66% of them were female, and the average age of the cohort was 61.4 years of age. 61% of patients underwent carpal tunnel release or trigger finger release. For the entire cohort, correlation coefficients comparing SANE to quickDASH and PROMIS across each time point were moderate with statistical significant (Table 1). Measuring responsiveness across the combined cohort, mean effect sizes for SANE, quickDASH and PROMIS were 1.09, 1.04, and 0.90 with standard deviations of 0.18, 0.19, and 0.06 respectively.
For individual pathologies, moderate effect sizes (Cohen's d >0.5) in SANE were seen in carpal tunnel release, distal radius fixation, and trigger finger release at all time points. SANE for CMC arthroplasty failed to show moderate effect size at one month, but later showed large effect sizes after that point.
Conclusions: Using the single question PRO, SANE, in hand pathologies is both valid and reliable compared to previously studied patient reported outcome measurements. However, the precise validity and responsiveness measurements change over time within the first 12 months post-surgery.
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