The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery (original) (raw)
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Acta Orthopaedica, 2000
The disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered regionspecific outcome instrument developed to measure upperextremity disability and symptoms. The DASH consists mainly of a 30-item disability/symptom scale. We performed cross-cultural adaptation of the DASH to Swedish, using a process that included double forward and backward translations, expert and lay review, as well as field-testing to achieve linguistic and conceptual equivalence. The Swedish version's reliability and validity were then evaluated in 176 patients with upper-extremity conditions. The patients completed the DASH and SF-12 generic health questionnaire before elective surgery or physical therapy. Internal consistency of the DASH was high (Cronbach alpha 0.96). Test-retest reliability, evaluated in a subgroup of 67 patients who completed the DASH on two occasions, with a median interval of 7 days, was excellent (intraclass correlation coefficient 0.92). Construct validity was shown by a positive correlation of DASH scores with the SF-12 scores (worse upper-extremity disability correlating with worse general health), stronger correlation with the SF-12 physical than with the mental health component, correlation of worse DASH scores with worse self-rated global health, and ability to discriminate among conditions known to differ in severity. The Swedish version of the DASH is a reliable and valid instrument that can provide a standardized measure of patient-centered outcomes in upper-extremity musculoskeletal conditions. n The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire Reliability and validity of the Swedish version evaluated in 176 patients
BMC musculoskeletal disorders, 2006
The 30-item disabilities of the arm, shoulder and hand (DASH) questionnaire is increasingly used in clinical research involving upper extremity musculoskeletal disorders. From the original DASH a shorter version, the 11-item QuickDASH, has been developed. Little is known about the discriminant ability of score changes for the QuickDASH compared to the DASH. The aim of this study was to assess the performance of the QuickDASH and its cross-sectional and longitudinal validity and reliability. The study was based on extracting QuickDASH item responses from the responses to the full-length DASH questionnaire completed by 105 patients with a variety of upper extremity disorders before surgery and at follow-up 6 to 21 months after surgery. The DASH and QuickDASH scores were compared for the whole population and for different diagnostic groups. For longitudinal construct validity the effect size and standardized response mean were calculated. Analyses with ROC curves were performed to comp...
The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 2005
The Disability of Arm, Shoulder and Hand (DASH) questionnaire is a standardized measure which captures the patients' own perspective of their upper extremity health status. Based on the scores of the DASH modules: symptoms, function and sport, this follow-up study of 590 hand-injured subjects from 11 diagnostic groups evaluated impairments and disabilities perceived 2 to 5 years postoperatively. Secondly, we explored the relationships between the diagnostic groups at the individual DASH item level.
Joint Bone Spine, 2008
Objective: To assess the reliability and validity of the French version of the Disability of the Arm, Shoulder and Hand-Disability/Symptom (F-DASH-D/S) scale in patients with shoulder disorders. Methods: We included 150 patients (98 women) with shoulder conditions intending to undergo medical and/or physical therapy at our institution. Parameters recorded were age, sex, disease duration, body mass index, pain scores at rest and during activities, and perceived disability on a visual analog scale (VAS, 0e100 mm). Subjective assessment of activities of daily living (ADL), active range of motion (ROM), and measurement of abduction strength (Strength) were assessed using the Constant scale. Internal consistency was evaluated with the Cronbach's alpha. Test-retest reliability was analyzed by intraclass correlation coefficient (ICC) and the Bland and Altman method. Construct validity was investigated with the Spearman rank correlation coefficient, and a factor analysis was performed. Results: Internal consistency was high, with a Cronbach's alpha coefficient of 0.96. The ICC value (0.95) suggested excellent test-retest reliability. Correlation of the F-DASH-D/S score with VAS score of disability (r ¼ 0.78), ADL score (r ¼ À 0.76), VAS score of pain during activities (r ¼ 0.64), Strength score (r ¼ À 0.63), ROM score (r ¼ À 0.57), VAS score of pain at rest (r ¼ 0.52), disease duration (r ¼ 0.38), age (r ¼ 0.28), and body mass index (r ¼ 0.24) indicated good construct validity. Factor analysis identified five factors accounting for 66.5% of the total variance. Each factor could be easily clinically interpreted. Conclusion: The French version of the DASH-D/S scale is a reliable and valid instrument for the assessment of disability in shoulder disorders.
Danish medical journal, 2014
This prospective cohort study in consecutive shoulder patients sought to determine the minimal, clinically important difference of the Danish version of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and to evaluate patient responsiveness to it. The study was undertaken at the Outpatient Clinic of the Department of Orthopaedic Surgery, Viborg Regional Hospital, Denmark. During clinical examination, patients completed a baseline questionnaire including the DASH questionnaire, the EuroQol-5D index and the EuroQol-VAS. A follow-up questionnaire concerning the patient's global impression of change was posted to the patients eight to nine weeks after the initial assessment. Responsiveness was analysed by correlation analysis and receiver-operating characteristic curve statistics. Using the optimal cut-off point of the receiver-operating characteristic curve, the minimal, clinically important difference was determined. A total of 81 patients with a variety of shou...
BMC Musculoskeletal Disorders, 2008
The International Classification of Functioning, Disability and Health (ICF) model of the consequences of disease identifies three health outcomes, impairment, activity limitations and participation restrictions. However, few orthopaedic health outcome measures were developed with reference to the ICF. This study examined the ability of a valid and frequently used measure of upper limb function, namely the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), to operationalise the ICF.
Archives of Physical Medicine and Rehabilitation, 2010
Franchignoni F, Giordano A, Sartorio F, Vercelli S, Pascariello B, Ferriero G. Suggestions for refinement of the Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH): a factor analysis and Rasch validation study.To perform a comprehensive psychometric analysis of Disabilities of the Arm, Shoulder and Hand (DASH) to examine its properties and provide insights for an improved version.Methodologic research on cross-sectional data from a convenience sample.A free-standing rehabilitation center.Outpatients and inpatients (N=238; 56% men; mean age, 52.2y) with upper-extremity musculoskeletal disorders.The official Italian version of DASH was analyzed by factor (both explorative and confirmatory) and Rasch analysis for evaluating dimensionality, functioning of rating scale categories, item fit, hierarchy of item difficulties, and reliability indices.Not applicable.Factor analysis established the presence of 3 underlying constructs related to manual functioning (items 1–5, 7–11, 16–18, 20, 21), shoulder range of motion (items 6, 12–15, 19), and symptoms and consequences (items 22–30). Rating scale diagnostics showed category malfunctioning. The fit to the Rasch model was good for all items except 4 (items 20, 21, 25, 26). Ten item pairs had high residual correlations after subtraction of the Rasch dimension (local dependency). A test model based on the 3 subscales suggested by factor analysis and corrected categories still showed misfitting in items 21 (“Sexual Activities”) and 26 (“Tingling”) and the presence of some dependent items.Unidimensionality and the key domains identified by the original developers as the theoretic framework of DASH were not confirmed by our analyses. The response categories showed misfunctioning. “Sexual Activities” and “Tingling” misfit the Rasch model. Further detailed investigations of DASH are warranted, both to confirm these results in different health conditions and cultures, and to reanalyze in-depth content validity issues regarding the questionnaire.