Patient Rated Wrist Evaluation
Authors: Alfie Veronica , Gallucci Gerardo , Boretto Jorge , Donndorff Agustin , De Carli Pablo 
Published: September 2016

Objective: Validated outcome measures are useful tools in hand surgery. Patient Rated Wrist Evaluation (PRWE) is a recognized instrument that was originally developed in English in Canada in 1996. It assessed pain and function in the wrist area and recently has demonstrated optimal reliability, validity, and responsiveness. It is also able to detect even small changes in the status of the injuries around the wrist. It has been translated and culturally adapted in several languages; however, there is not a Spanish validated version available in the literature. More than 400 million people have Spanish as native language and many non-Hispanic countries have Spanish-speaking citizens. The aim of this study is to translate in Spanish and perform a cross-cultural adaptation of the PRWE (PRWE-S) and then evaluate its psychometric attributes in a population of patients with distal radius fracture. Material and Methods: A 5-steps guideline for the process of cross-cultural adaptation of self-report measures as described by Guillemin and colleagues was used for the PRWE-S. Ethics approval of the Committee of the Hospital where this research was performed was obtained. A translation committee was created for this purpose with 4 translators, 8 researchers, and 2 methodologists. Twenty adult patients with a distal radius fracture without cast or orthoses for at least 10 days were included in the first stage. An oral informed consent was obtained and the data were anonymous to the researchers. Psychometric properties of PRWE-S were tested in the second stage in 30 patients with distal radius fracture. A PRWE-S and a QuickDASH were completed both simultaneously at first interview with the aim to assess the criterion validity between the Spanish PRWE and a gold standard instrument. The preset hypothesis about the expected relationship between those instruments is supposed to be that the value of the PRWE-S was expected to be approximately the same as the result of the QuickDASH. Between 7 and 14 days after, patients completed newly the PRWE-S to test the test-retest reliability. Statistical Analysis: Construct validity between PRWE-S and QuickDASH was measured with Spearman’s correlation test for nonparametric data and intraclass correlation coefficient (ICC) was used to assess test-retest reliability. Cronbach’s alpha was selected as a measurement of internal consistency. Results: After completing the 5-step process, we arrived to a final version of the PRWE-S. Spearman’s correlation test for analysis of the criterion validity indicates a strong positive correlation between the PRWE-S and the QuickDASH (0.75). The internal consistency according to the Cronbach’s alpha was .96 (0 implies no correlation and 1 higher correlation) while the ICC (test-retest reliability) was moderate (0.46). Conclusions: A Spanish version of the PRWE was achieved. Psychometric attributes were assessed that demonstrated good criterion validity and reliability in a group of patients with distal radius fracture. This tool can be used in Hispanic patients with injuries around the wrist to evaluate aspects as pain and function.