Journal Article

Determining responsiveness and meaningful changes for the Musculoskeletal Health Questionnaire (MSK-HQ) for use across musculoskeletal care pathways

Kang, Sujin, Barker, Karen L, Ogollah, Reuben, Rees, Jonathan, Smith, Stephanie, Benedetto, Elena, Galloway, James B, Hill, Jonathan C, Hay, Elaine, Ellis, Benjamin, Smith, James, Glyn-Jones, Sion, Beard, David, Fitzpatrick, Ray, Price, Andrew James

2019

Overview

ObjectivesWe have previously developed and validated the Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ) for use across musculoskeletal care pathways, showing encouraging psychometric test results. The objective of this study was to determine the responsiveness of MSK-HQ following MSK treatments and to determine the minimally important change (MIC).SettingWe collected data in four cohorts from community physiotherapy and secondary-care orthopaedic hip, knee and shoulder clinics.Participants592 individuals were recruited; 210 patients treated with physiotherapy for a range of MSK conditions in primary care; 150 patients undergoing hip replacement, 150 patients undergoing knee replacement and 82 undergoing shoulder surgery in secondary care.Outcome measuresPreoperative data were collected including the MSK-HQ, European Quality of Life-5D (EQ-5D) and the OHS, OKS or OSS in each joint-specific group. The same scores, together with anchor questions, were collected postintervention at 3 months for the physiotherapy group and 6 months for all others. Following COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) guidelines, responsiveness was assessed using correlation between scores and the MIC was calculated for the entire cohort using receiver operating characteristic curve analysis.ResultsThe MSK-HQ demonstrated strong correlation (R=0.73) with EQ-5D across the entire cohort and with each of the joint-specific Oxford scores (hip R=0.87, knee R=0.92 and shoulder R=0.77). Moderate correlation was seen between MSK-HQ and EQ-5D across each individual group (R value range 0.60–0.68), apart from the hip group where correlation was strong (R=0.77). The effect size with MSK-HQ was 0.93, in the entire cohort, double that measured with EQ-5D (0.43). In all subgroups, MSK-HQ measured a greater treatment effect compared with EQ-5D. The MIC is 5.5 (95% CI 2.7 to 8.3).ConclusionOur study demonstrates that the MSK-HQ questionnaire is responsive to change across a range of musculoskeletal conditions, supporting its use as a generic MSK measurement instrument.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Adult / Aged / Arthroplasty, Replacement, Hip / Arthroplasty, Replacement, Knee / Back pain / Female / Health care / Humans / Joint surgery / Longitudinal Studies / Male / Medical referrals / Middle Aged / minimally important change / MSK-HQ / musculoskeletal / Musculoskeletal Diseases - therapy / musculoskeletal disorders / patient reported outcome / Patient-Centred Medicine / Patients / Physical therapists / Physical Therapy Modalities / Postoperative Period / Preoperative Period / Primary care / Quality of life / responsiveness / ROC Curve / Shoulder / Shoulder Joint - surgery / Surgery / Surveys and Questionnaires - statistics & numerical data / Systematic review / Treatment Outcome