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Open Access 01-12-2020 | Research

Measurement properties of the musculoskeletal health questionnaire (MSK-HQ): a between country comparison

Authors: David Høyrup Christiansen, Gareth McCray, Trine Nøhr Winding, Johan Hviid Andersen, Kent Jacob Nielsen, Sven Karstens, Jonathan C. Hill

Published in: Health and Quality of Life Outcomes | Issue 1/2020

Abstract

Background

The Musculoskeletal Health Questionnaire (MSK-HQ) has been developed to measure musculoskeletal health status across musculoskeletal conditions and settings. However, the MSK-HQ needs to be further evaluated across settings and different languages.

Objective

The objective of the study was to evaluate and compare measurement properties of the MSK-HQ across Danish (DK) and English (UK) cohorts of patients from primary care physiotherapy services with musculoskeletal pain.

Methods

MSK-HQ was translated into Danish according to international guidelines. Measurement invariance was assessed by differential item functioning (DIF) analyses. Test-retest reliability, measurement error, responsiveness and minimal clinically important change (MCIC) were evaluated and compared between DK (n = 153) and UK (n = 166) cohorts.

Results

The Danish version demonstrated acceptable face and construct validity. Out of the 14 MSK-HQ items, three items showed DIF for language (pain/stiffness at night, understanding condition and confidence in managing symptoms) and three items showed DIF for pain location (walking, washing/dressing and physical activity levels). Intraclass Correlation Coefficients for test-retest were 0.86 (95% CI 0.81 to 0.91) for DK cohort and 0.77 (95% CI 0.49 to 0.90) for the UK cohort. The systematic measurement error was 1.6 and 3.9 points for the DK and UK cohorts respectively, with random measurement error being 8.6 and 9.9 points. Receiver operating characteristic (ROC) curves of the change scores against patients’ own judgment at 12 weeks exceeded 0.70 in both cohorts. Absolute and relative MCIC estimates were 8–10 points and 26% for the DK cohort and 6–8 points and 29% for the UK cohort.

Conclusions

The measurement properties of MSK-HQ were acceptable across countries, but seem more suited for group than individual level evaluation. Researchers and clinicians should be aware that some discrepancy exits and should take the observed measurement error into account when evaluating change in scores over time.

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Note: the ETS Delta Scale has three categorisations for DIF; (A) Negligible: non-significant or effect size lower than 1, (B) Intermediate: neither A nor C true, (C) Large: Effect size > 1.5 AND significantly different from an effect size of 1. See the reference for the calculation of the effect size.

Briggs AM, Cross MJ, Hoy DG, Sanchez-Riera L, Blyth FM, Woolf AD, March L. Musculoskeletal health conditions represent a global threat to healthy aging: a report for the 2015 World Health Organization world report on ageing and health. Gerontologist. 2016;56(Suppl 2):S243–55.PubMedCrossRef

Buchbinder R, van Tulder M, Oberg B, Costa LM, Woolf A, Schoene M, Croft P. Lancet low Back pain series working group. Low back pain: a call for action. Lancet. 2018;391(10137):2384–8.PubMedCrossRef

Carragee EJ, Alamin TF, Miller JL, Carragee JM. Discographic, MRI and psychosocial determinants of low back pain disability and remission: a prospective study in subjects with benign persistent back pain. Spine J. 2005;5(1):24–35.PubMedCrossRef

Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskelet Disord. 2008;9:116–2474–9-116.

Hartvigsen L, Kongsted A, Hestbaek L. Clinical examination findings as prognostic factors in low back pain: a systematic review of the literature. Chiropr Man Therap. 2015;23:13–015-0054-y. eCollection 2015.

Dawson J, Doll H, Fitzpatrick R, Jenkinson C, Carr AJ. The routine use of patient reported outcome measures in healthcare settings. BMJ. 2010;340:c186.PubMedCrossRef

Angst F, Schwyzer HK, Aeschlimann A, Simmen BR, Goldhahn J. Measures of adult shoulder function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and its short version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society standardized shoulder assessment form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI). Arthritis Care Res (Hoboken). 2011;63(Suppl 11):S174–88.CrossRef

Chapman JR, Norvell DC, Hermsmeyer JT, Bransford RJ, DeVine J, McGirt MJ, Lee MJ. Evaluating common outcomes for measuring treatment success for chronic low back pain. Spine (Phila Pa 1976). 2011;36(21 Suppl):S54–68.CrossRef

Schellingerhout JM, Verhagen AP, Heymans MW, Koes BW, de Vet HC, Terwee CB. Measurement properties of disease-specific questionnaires in patients with neck pain: a systematic review. Qual Life Res. 2012;21(4):659–70.PubMedCrossRef

10.

Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care Res (Hoboken). 2011;63(Suppl 11):S208–28.CrossRef

11.

Mose S, Christiansen DH, Jensen JC, Andersen JH. Widespread pain - do pain intensity and care-seeking influence sickness absence? - a population-based cohort study. BMC Musculoskelet Disord. 2016;17(1):197 -016-1056-1.PubMedPubMedCentralCrossRef

12.

Swiontkowski MF, Engelberg R, Martin DP, Agel J. Short musculoskeletal function assessment questionnaire: validity, reliability, and responsiveness. J Bone Joint Surg Am. 1999;81(9):1245–60.PubMedCrossRef

13.

Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, Jorgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233–7.PubMedCrossRef

14.

Hill JC, Kang S, Benedetto E, Myers H, Blackburn S, Smith S, Dunn KM, Hay E, Rees J, Beard D, Glyn-Jones S, Barker K, Ellis B, Fitzpatrick R, Price A. Development and initial cohort validation of the Arthritis Research UK musculoskeletal health questionnaire (MSK-HQ) for use across musculoskeletal care pathways. BMJ Open. 2016;6(8):e012331 -2016-012331.PubMedPubMedCentralCrossRef

15.

Prinsen CAC, Mokkink LB, Bouter LM, Alonso J, Patrick DL, de Vet HCW, Terwee CB. COSMIN guideline for systematic reviews of patient-reported outcome measures. Qual Life Res. 2018;27(5):1147–57.PubMedPubMedCentralCrossRef

16.

Terwee CB, Roorda LD, Dekker J, Bierma-Zeinstra SM, Peat G, Jordan KP, Croft P, de Vet HC. Mind the MIC: large variation among populations and methods. J Clin Epidemiol. 2010;63(5):524–34.PubMedCrossRef

17.

Terwee CB, Bot SD, de Boer MR, van der Windt AWM, Knol DL, Dekker J, Bouter LM, de Vet HC. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.PubMedCrossRef

18.

Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health. 2005;8(2):94–104.PubMedCrossRef

19.

Brooks R. EuroQol: the current state of play. Health Policy. 1996;37(1):53–72.PubMedCrossRef

20.

Janssen MF, Pickard AS, Golicki D, Gudex C, Niewada M, Scalone L, Swinburn P, Busschbach J. Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study. Qual Life Res. 2013;22(7):1717–27.PubMedCrossRef

21.

van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D, Lloyd A, Scalone L, Kind P, Pickard AS. Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health. 2012;15(5):708–15.PubMedCrossRef

22.

Schonnemann JO, Eggers J. Validation of the Danish version of the quick-disabilities of arm, shoulder and hand questionnaire. Dan Med J. 2016;63(12):A5306.PubMed

23.

Budtz CR, Andersen JH, de Vos Andersen NB, Christiansen DH. Responsiveness and minimal important change for the quick-DASH in patients with shoulder disorders. Health Qual Life Outcomes. 2018;16(1):226 -018-1052-2.PubMedPubMedCentralCrossRef

24.

Lauridsen HH, Hartvigsen J, Manniche C, Korsholm L, Grunnet-Nilsson N. Danish version of the Oswestry disability index for patients with low back pain. Part 1: Cross-cultural adaptation, reliability and validity in two different populations. Eur Spine J. 2006;15(11):1705–16.PubMedCrossRef

25.

Lauridsen HH, Hartvigsen J, Manniche C, Korsholm L, Grunnet-Nilsson N. Danish version of the Oswestry disability index for patients with low back pain. Part 2: sensitivity, specificity and clinically significant improvement in two low back pain populations. Eur Spine J. 2006;15(11):1717–28.PubMedCrossRef

26.

Lauridsen HH, O'Neill L, Kongsted A, Hartvigsen J. The Danish Neck Disability Index: New Insights into Factor Structure, Generalizability, and Responsiveness. Pain Pract. 2016.

27.

Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee injury and osteoarthritis outcome score (KOOS)--development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998;28(2):88–96.PubMedCrossRef

28.

Klassbo M, Larsson E, Mannevik E. Hip disability and osteoarthritis outcome score. An extension of the Western Ontario and McMaster universities osteoarthritis index. Scand J Rheumatol. 2003;32(1):46–51.PubMedCrossRef

29.

Nilsdotter AK, Lohmander LS, Klassbo M, Roos EM. Hip disability and osteoarthritis outcome score (HOOS)--validity and responsiveness in total hip replacement. BMC Musculoskelet Disord. 2003;4:10.PubMedPubMedCentralCrossRef

30.

Fayers PM, Machin D. Quality of life: the assesment, analysis and interpretation of patient-reported outcomes: 2nd ed. West Sussex, England: Wiley; 2007.

31.

Cohen J. Statistical power analysis for the social sciences. 2nd ed. Hillsdale, NJ: Laurence Erlbaum; 1998.

32.

Revicki D, Hays RD, Cella D, Sloan J. Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. J Clin Epidemiol. 2008;61(2):102–9.PubMedCrossRef

33.

R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2018. http://www.R-project.org/. Accessed 07/01 2018.

34.

Magis D, Beland S, Tuerlinckx F, De Boeck P. A general framework and an R package for the detection of dichotomous differential item functioning. Behav Res Methods. 2010;42(3):847–62.PubMedCrossRef

35.

Dorans NJ, Holland PW. DIF DETECTION AND DESCRIPTION: MANTEL-HAENSZEL AND STANDARDIZATION 1, 2. ETS. Research Report Series. 1992(1):pp.i-40.ly.

36.

Froud R, Abel G. Using ROC curves to choose minimally important change thresholds when sensitivity and specificity are valued equally: the forgotten lesson of pythagoras. theoretical considerations and an example application of change in health status. PLoS One. 2014;9(12):e114468.PubMedPubMedCentralCrossRef

37.

Frahm Olsen M, Bjerre E, Hansen MD, Tendal B, Hilden J, Hrobjartsson A. Minimum clinically important differences in chronic pain vary considerable by baseline pain and methodological factors: systematic review of empirical studies. J Clin Epidemiol 2018.

38.

DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44(3):837–45.PubMedCrossRef

39.

Gwaltney CJ, Shields AL, Shiffman S. Equivalence of electronic and paper-and-pencil administration of patient-reported outcome measures: a meta-analytic review. Value Health. 2008;11(2):322–33.PubMedCrossRef

40.

Terluin B, Eekhout I, Terwee CB. The anchor-based minimal important change, based on receiver operating characteristic analysis or predictive modeling, may need to be adjusted for the proportion of improved patients. J Clin Epidemiol. 2017;83:90–100.PubMedCrossRef

41.

Terluin B, Eekhout I, Terwee CB, de Vet HC. Minimal important change (MIC) based on a predictive modeling approach was more precise than MIC based on ROC analysis. J Clin Epidemiol. 2015;68(12):1388–96.PubMedCrossRef

42.

de Vet HC, Terwee CB, Mokkink LB, Knol DL,. Measurement in medicine: a practical guide. Cambridge University Press.; 2011.

43.

Chiarotto A, Maxwell LJ, Terwee CB, Wells GA, Tugwell P, Ostelo RW. Roland-Morris disability questionnaire and Oswestry disability index: which has better measurement properties for measuring physical functioning in nonspecific low Back pain? Systematic Review and Meta-Analysis. Phys Ther. 2016;96(10):1620–37.PubMedCrossRef

44.

Bouffard J, Bertrand-Charette M, Roy JS. Psychometric properties of the musculoskeletal function assessment and the short musculoskeletal function assessment: a systematic review. Clin Rehabil. 2016;30(4):393–409.PubMedCrossRef

45.

Fayers PM, Machin D. Scores and measurements:validity, reliability, sensitivity. In: anonymous quality of life: the assessment, analysis and interpretation of patient reported outcomes. West Sussex, England: Wiley; 2007.

Title: Measurement properties of the musculoskeletal health questionnaire (MSK-HQ): a between country comparison
Authors: David Høyrup Christiansen
Gareth McCray
Trine Nøhr Winding
Johan Hviid Andersen
Kent Jacob Nielsen
Sven Karstens
Jonathan C. Hill
Publication date: 01-12-2020
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2020
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/s12955-020-01455-4

At a glance: The STEP trials

Springer Medicine

Measurement properties of the musculoskeletal health questionnaire (MSK-HQ): a between country comparison

Abstract

Background

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusions

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