Versus Arthritis Musculoskeletal Health Questionnaire (MSK-HQ)

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The Versus Arthritis Musculoskeletal Health Questionnaire (MSK-HQ) is a Patient Reported Outcome which has been developed to assess outcomes in patients with a variety of musculoskeletal conditions.

Background of the MSK-HQ

Musculoskeletal (MSK) pain is the single greatest cause of years lived with disability. This can include osteoarthritis, inflammatory disorders and musculoskeletal disorders such as back, neck, shoulder, hip, and knee pain. The health impact of musculoskeletal conditions, cannot be summarised with blood tests or imaging/scans. Patient Reported Outcome (PRO) Measures, however, are well suited to this purpose, but different PROMs are used for each MSK condition which can cause practical difficulties, especially for people with pain in multiple places.

MSK-HQ was developed as a generic, single musculoskeletal outcome measure that can be used throughout the healthcare pathway and with patients with different musculoskeletal conditions.


The MSK-HQ was co-produced with patients and clinicians to identify aspects of MSK health important to both. A consensus workshop provided initial domains, and individual items were formulated. Stakeholder acceptability was assessed during a second workshop and a candidate MSK-HQ was then taken forward to quantitative testing in physiotherapy and orthopaedic cohorts (n=570).

The Versus Arthritis MSK-HQ contains 14 items and measures the health status in patients with MSK conditions over the past two weeks

Aims of patient and public involvement

Patient and public involvement and engagement (PPIE) was used to investigate individual symptoms and the health domains. This helped to distinguish which issues were of most concern to those affected by different musculoskeletal conditions.

Impact of patient and public involvement

Using a consensus process, involving key stakeholders, participants successfully identified and prioritised the following key outcomes for inclusion in the MSK-HQ (in priority order):

  • Pain severity (in the day and night)
  • Physical function (walking and dressing)
  • Physical activity level
  • Pain interference (with work/daily routine and with social activities/hobbies)
  • Difficulty with sleep, fatigue/low energy levels
  • Emotional well-being (anxiety and mood)
  • Understanding of diagnosis and treatment
  • Confidence to self-manage (pain self-efficacy) independence
  • Overall impact from symptoms

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Scoring system

User (scoring) guide for the Versus Arthritis Musculoskeletal Health Questionnaire (MSK-HQ)

On the questionnaire, the following guidance is given in the preamble at the top of the form:

“Please focus on the particular health problem(s) for which you sought treatment from this service.”

If this is not relevant to your use of the MSK-HQ, please delete this sentence. It will not affect the formatting or the results of the questionnaire.

No other changes to the formatting, order or content of the MSK questions and responses, or the copyright message, should be made without the written permission of the Clinical Outcomes team at Oxford University Innovation.

Scoring the Musculoskeletal Health Questionnaire (MSK-HQ)

All of the questions in the MSK-HQ are presented in the same way, with a small number to the right of each response option box. This associated number, corresponding to the ticked response, is to be used to score the MSK-HQ.

The MSK-HQ is scored on a range of 0-56, with a better score indicating better MSK-HQ health status. In order to calculate the respondents total score, add the numbers next to the box that the respondent has ticked on the questionnaire form. The total of all of these scores, will give the overall result of the MSK-HQ.

Minimal Important Change (MIC)

The minimally important change has been calculated as 5.5 (95% CI 2.7 – 8.3). This was calculated using results from a study of 610 individuals recruited from 4 MSK clinical pathways; patients treated with physiotherapy for a range of MSK conditions in primary care and patients undergoing hip replacement, knee replacement or shoulder surgery in secondary care.

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Administration Methods

Pen and Paper ePRO/eCOA – Computer-based administration Telephone Interview

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Authorised eCOA vendors

Ascenti Physio

medq logo

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MSK-HQ was developed as a collaboration between Keele and Oxford Universities. The development of MSK-HQ was supported by Versus Arthritis and the NHS.

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