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Measurement properties of the Arm Function in Multiple Sclerosis Questionnaire (AMSQ): a study based on Classical Test Theory
Authors:Lisette M van Leeuwen  Lidwine B Mokkink  Christian P Kamm  Vincent de Groot  Pauline van den Berg  Raymond W J G Ostelo
Institution:1. Department of Otolaryngology – Head and Neck Surgery, Section Ear &2. Hearing, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;3. Department of Epidemiology and Biostatistics, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands;4. Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;5. Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands;6. Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands;7. Nieuw Unicum Zandvoort, Zandvoort, The Netherlands;8. Department of Health Sciences, Faculty of Earth and Life Science, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
Abstract:Purpose: The construct validity, test–retest reliability, and measurement error of the Arm Function in Multiple Sclerosis Questionnaire (AMSQ) were examined. Additionally, the influence of administration-method on reliability and measurement error was investigated.

Method: 112 Dutch adult MS-patients from an academic- and a residential care-facility participated. Questionnaires were administered on paper, online or as interview, and patients performed several performance tests. Construct validity was assessed by testing pre-defined hypotheses. Reliability was assessed using Intraclass Correlation Coefficients (ICCs), Standard Error of Measurements (SEMs) and Smallest Detectable Changes (SDCs).

Results: For construct validity (N?=?105) 9 of 13 hypotheses were confirmed (69%). As expected, the AMSQ showed moderate to strong relationships with the instruments measuring similar constructs. The test–retest reliability coefficient was 0.96 (95% Confidence Interval 0.94–0.97); SEM was 6.3 (6.3% of scale range); SDC was 17.5 (on a sale from 0 to 100). Different administration-methods showed good reliability (ICC 0.88–0.94) and small standard errors (SEM 5.6–7.2).

Conclusion: The AMSQ shows satisfying results for validity and excellent reliability; allowing for proper use in research. Due to a large SDC value, caution is needed when using the AMSQ in individual patient care. Further research should determine whether the SDC is smaller than the minimal important change.
  • Implications for Rehabilitation
  • The Arm Function in Multiple Sclerosis Questionnaire (AMSQ) measures activity limitations due to hand and arm functioning in patients with Multiple Sclerosis (MS).

  • Results of this study confirm adequate validity and reliability of the AMSQ in patient with MS.

  • The equivalence of scores from online, paper or interview administration is supported.

  • A change score of ≥18 points on the scale of the AMSQ (on a scale 0–100) needs to occur to be certain a change beyond measurement error has occurred in an individual patient.

Keywords:Arm function in multiple sclerosis questionnaire  AMSQ  activity limitations  hypotheses testing  test–retest reliability  standard error of measurement  smallest detectable change
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