Cross-Cultural Adaptation and Psychometric Validation of the Arabic Duruöz Hand Index: A Reliable Patient-Reported Measure for Hand Disability in Arabic-Speaking Populations.

Authors

Marc Boutros, Guy Awad, Caren Hassan, Shaza Hammad, Antonella Leba, Tia Maria Akoury, Sami Kais, Sami Roukoz, Rami El Abiad

Published in

Hand (New York, N.Y.). Pages 15589447261496353. Oct 28, 2026. Epub Oct 28, 2026.

Abstract

The Duruöz Hand Index (DHI) is a validated patient-reported outcome measure assessing hand-related functional disability. No formally translated and validated Arabic version previously existed. This study aimed to translate, culturally adapt, and psychometrically validate the Arabic version (DHI-AR).
A prospective cross-sectional validation study was conducted following established cross-cultural adaptation guidelines, including forward translation, reconciliation, back-translation, expert review, and pilot testing. Adults (≥18 years) with hand or wrist pain or functional limitation were recruited from 2 outpatient clinics. Participants completed the DHI-AR and the validated Arabic Patient-Rated Wrist/Hand Evaluation (PRWHE-AR). A clinically stable subgroup completed the DHI-AR again after 5 to 10 days. Analyses assessed internal consistency, test-retest reliability, measurement error, structural validity, convergent validity, and interpretability.
A total of 439 participants were included; 76 completed the retest. Internal consistency was excellent (Cronbach's α = 0.980). Test-retest reliability was excellent (intraclass correlation coefficient [ICC](2,1) = 0.993; 95% CI, 0.990-0.996). Measurement error was low (SEM = 2.30), with minimal detectable change values of 6.38 points for individuals and 0.73 for groups (0-90 scale). Structural validity supported essential unidimensionality (74.82% variance explained). Convergent validity with the PRWHE-AR was strong (ρ = 0.793-0.868; P < .001). Floor and ceiling effects were less than 15%.
The DHI-AR demonstrated strong internal consistency, excellent test-retest reliability, low measurement error, a predominantly unidimensional component structure, and strong convergent validity. Responsiveness, minimal clinically important difference, and measurement invariance require further evaluation.

PMID:
42947658
Bibliographic data and abstract were imported from PubMed on 28 Oct 2026.

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