Validation of a Simple Instrument of Fast Application to Track Disability in Leprosy Patients.

Objective To evaluate a simple and fast diagnostic instrument to be used by any health professional to track the disability presented by leprosy patients. Method Validation study of a diagnostic test performed in a sample of 156 leprosy patients to track functional disability through the shortened disabilities of arm, shoulder, and hand (QuickDASH) questionnaire . The simplified neurological assessment proposed by the World Health Organization was used as a reference. A receiver operating characteristic (ROC) curve was constructed to determine the cutoff point of QuickDASH that best discriminated patients with functional disability caused by leprosy. Results We identified 86 (55.5%) patients with functional disability by simplified neurological evaluation. The performance of the QuickDASH instrument showed that, at a cut-off point of 30 points, the sensitivity and specificity were 72.1% and 68.1% (accuracy of 70.3%), respectively, to identify functional disability, with a positive predictive value of 73.8%. Conclusion The QuickDASH instrument showed good accuracy to track functional disability in leprosy patients, and it may be useful in clinical practice of primary and general outpatient care, with the goal of identifying patients who need specialized reference for the prevention and treatment of this condition.

Validation of a Simple Instrument of Fast Application to Track Disability in Leprosy Patients / Validação de um instrumento simples e de aplicação rápida para rastrear incapacidade em pacientes com hanseníase

Abstract Objective To evaluate a simple and fast diagnostic instrument to be used by any health professional to track the disability presented by leprosy patients. Method Validation study of a diagnostic test performed in a sample of 156 leprosy patients to track functional disability through the shortened disabilities of arm, shoulder, and hand (QuickDASH) questionnaire. The simplified neurological assessment proposed by the World Health Organization was used as a reference. A receiver operating characteristic (ROC) curve was constructed to determine the cutoff point of QuickDASH that best discriminated patients with functional disability caused by leprosy. Results We identified 86 (55.5%) patients with functional disability by simplified neurological evaluation. The performance of the QuickDASH instrument showed that, at a cut-off point of 30 points, the sensitivity and specificity were 72.1% and 68.1% (accuracy of 70.3%), respectively, to identify functional disability, with a positive predictive value of 73.8%. Conclusion The QuickDASH instrument showed good accuracy to track functional disability in leprosy patients, and it may be useful in clinical practice of primary and general outpatient care, with the goal of identifying patients who need specialized reference for the prevention and treatment of this condition.

Resumo Objetivo Avaliar um instrumento diagnóstico simples e rápido a ser utilizado por qualquer profissional da saúde para rastrear a incapacidade apresentada por pacientes com hanseníase. Método Estudo de validação de teste de diagnóstico realizado em uma amostra de 156 pacientes com hanseníase para rastrear incapacidade funcional, por meio do questionário abreviado disabilities of arm, shoulder, and hand (QuickDASH). A avaliação neurológica simplificada proposta pela Organização Mundial da Saúde foi utilizada como referência. Construiu-se a curva de características operacionais do receptor (ROC) para determinação do ponto de corte do QuickDASH que melhor discriminou pacientes com incapacidade funcional provocada pela hanseníase. Resultados Foram identificados 86 (55,5%) pacientes com incapacidade funcional pela avaliação neurológica simplificada. O desempenho do QuickDASH mostrou que, em ponto de corte de 30 pontos, a sensibilidade e a especificidade foram de 72,1% e 68,1% (acurácia de 70,3%), respectivamente, para identificar incapacidade funcional, com um valor preditivo positivo de 73,8%. Conclusão O instrumento QuickDASH mostrou boa acurácia para rastrear incapacidade funcional no paciente com hanseníase, podendo ser útil na prática clínica da atenção básica e ambulatorial geral, com o objetivo de identificar pacientes que necessitam de referência especializada para sua prevenção e tratamento.

Evaluation of surgical treatments for leprosy sequelae using the Salsa and Dash scales / Avaliação dos tratamentos cirúrgicos das sequelas de hanseníase pelas escalas Salsa e Dash

OBJECTIVE: to compare the SALSA and risk awareness scales with the DASH scale in assessments on leprosy surgery. METHOD: before the operation and 90 days afterwards, we applied the tests to 14 patients (11 females and three males) of ages from 28 to 67 years, who were operated between November 2011 and May 2012. RESULTS: the patients were evaluated after the operation using the SALSA and DASH scales, to measure their relationships and results. CONCLUSION: despite the small sample, this study showed that there were similar relationships of results between the SALSA/risk awareness and DASH scales...

OBJETIVO: comparar as escalas funcionais Salsa (Screening of Activity Limitation and Safety Awarenses)/consciência de risco e Dash (Disabilities of the Arm, Shouder, and Hand) nas avaliações de cirurgias hansênicas. MÉTODO: aplicamos os testes no pré-operatório e com 90 dias de pós-operatório em 14 pacientes, 11 do sexo feminino e três do masculino, entre 28 e 67 anos, operados de novembro de 2011 a maio de 2012. RESULTADOS: os pacientes foram avaliados no pós-operatório pelas escalas Salsa/consciência de risco e Dash para aferir suas relações e seus resultados. CONCLUSÃO: este estudo, apesar da casuística pequena, demonstrou que há relação similar dos resultados entre as escalas Salsa/consciência de risco e Dash...

Evaluation of surgical treatments for leprosy sequelae using the Salsa and Dash scales.

OBJECTIVE: to compare the SALSA and risk awareness scales with the DASH scale in assessments on leprosy surgery. METHOD: before the operation and 90 days afterwards, we applied the tests to 14 patients (11 females and three males) of ages from 28 to 67 years, who were operated between November 2011 and May 2012. RESULTS: the patients were evaluated after the operation using the SALSA and DASH scales, to measure their relationships and results. CONCLUSION: despite the small sample, this study showed that there were similar relationships of results between the SALSA/risk awareness and DASH scales.

OBJETIVO: comparar as escalas funcionais Salsa (Screening of Activity Limitation and Safety Awarenses)/consciência de risco e Dash (Disabilities of the Arm, Shouder, and Hand) nas avaliações de cirurgias hansênicas. MÉTODO: aplicamos os testes no pré-operatório e com 90 dias de pós-operatório em 14 pacientes, 11 do sexo feminino e três do masculino, entre 28 e 67 anos, operados de novembro de 2011 a maio de 2012. RESULTADOS: os pacientes foram avaliados no pós-operatório pelas escalas Salsa/consciência de risco e Dash para aferir suas relações e seus resultados. CONCLUSÃO: este estudo, apesar da casuística pequena, demonstrou que há relação similar dos resultados entre as escalas Salsa/consciência de risco e Dash.