DEVELOPMENT OF A MUSCULOSKELETAL EXTREMITY HEALTH-STATUS INSTRUMENT -THE MUSCULOSKELETAL FUNCTION ASSESSMENT INSTRUMENT

Despite an increasing reliance on the use of health status measures to assess and evaluate medical care, no single instrument is currently a vailable for use with the broad range of patients with musculoskeletal disorders of the extremities that is commonly seen in clinical practi ce. In this paper, we report on the development of the Musculoskeletal Function Assessment instrument, a 100-item self reported health statu s instrument that is designed to meet this need. The instrument was de veloped in two phases. During the first phase, items were selected on the basis of interviews with 135 patients and 12 clinicians and from r eviews of existing health status instruments. The items then were grou ped into categories. During the second phase, the instrument was teste d for reliability and content validity using a sample of 327 patients with one of five musculoskeletal disorders of the upper and lower extr emities (fractures, soft-tissue injuries, repetitive motion disorders, osteoarthritis, and rheumatoid arthritis). The patients were selected from both community and academic sites. The Musculoskeletal Function Assessment instrument met standards for test-retest reliability and in ternal consistency. Content validity also was demonstrated, based on a review of item selection procedures, expert opinion, and the distribu tion of scores on the instrument.