Use of condition-specific patient-reported outcome measures in clinical trials among patients with wrist osteoarthritis : a systematic review

Background. This paper aimed to identify condition-specific patient-reported outcome measures used in clinical trials among people with wrist osteoarthritis and summarise empirical peer-reviewed evidence supporting their reliability, validity, and responsiveness to change. Methods. A systematic review of randomised controlled trials among people with wrist osteoarthritis was undertaken. Studies reporting reliability, validity, or responsiveness were identified using a systematic reverse citation trail audit procedure. Psychometric properties of the instruments were examined against predefined criteria and summarised. Results. Thirteen clinical trials met inclusion criteria. The most common patient-reported outcome was the disabilities of the arm, shoulder, and hand questionnaire (DASH). The DASH, the Michigan Hand Outcomes Questionnaire (MHQ), the Patient Evaluation Measure (PEM), and the Patient-Reported Wrist Evaluation (PRWE) had evidence supporting their reliability, validity, and responsiveness. A post-hoc review of excluded studies revealed the AUSCAN Osteoarthritis Hand Index as another suitable instrument that had favourable reliability, validity, and responsiveness. Conclusions. The DASH, MHQ, and AUSCAN Osteoarthritis Hand Index instruments were supported by the most favourable empirical evidence for validity, reliability, and responsiveness. The PEM and PRWE also had favourable empirical evidence reported for these elements. Further psychometric testing of these instruments among people with wrist osteoarthritis is warranted.

Theories of learning mathematics

According to Karl Popper, widely regarded as one of the greatest philosophers of science in the 20th century, falsifiability is the primary characteristic that distinguishes scientific theories from ideologies – or dogma. For example, for people who argue that schools should treat creationism as a scientific theory, comparable to modern theories of evolution, advocates of creationism would need to become engaged in the generation of falsifiable hypothesis, and would need to abandon the practice of discouraging questioning and inquiry. Ironically, scientific theories themselves are accepted or rejected based on a principle that might be called survival of the fittest. So, for healthy theories on development to occur, four Darwinian functions should function: (a) variation – avoid orthodoxy and encourage divergent thinking, (b) selection – submit all assumptions and innovations to rigorous testing, (c) diffusion – encourage the shareability of new and/or viable ways of thinking, and (d) accumulation – encourage the reuseability of viable aspects of productive innovations.