DASH Outcome Measure: Difference between revisions
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== | == Introduction == | ||
[[Image:Arm.jpg|right|300px]] | [[Image:Arm.jpg|right|300px]] | ||
The '''Disabilities of the Arm, Shoulder and Hand (DASH)''' questionnaire is a 30-item questionnaire that looks at the ability of a patient to perform certain upper extremity activities.<ref name="dash">The DASH outcome measure. Available at http://www.dash.iwh.on.ca, Accessed March 12, 2011.</ref><ref name="Beaton">Beaton | The '''Disabilities of the Arm, Shoulder and Hand (DASH)''' questionnaire is a 30-item questionnaire that looks at the ability of a patient to perform certain upper extremity activities.<ref name="dash">The DASH outcome measure. Available at http://www.dash.iwh.on.ca, Accessed March 12, 2011.</ref><ref name="Beaton">Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C. [https://pubmed.ncbi.nlm.nih.gov/11382253/ Measuring the whole or the parts?: validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity.] Journal of Hand Therapy. 2001 Apr 1;14(2):128-42.</ref><ref name="Beaton 2">Beaton DE, Davis AM, Hudak P, McConnell S. [https://journals.sagepub.com/doi/10.1177/175899830100600401 The DASH (Disabilities of the Arm, Shoulder and Hand) outcome measure: what do we know about it now?.] The British Journal of Hand Therapy. 2001 Dec;6(4):109-18..</ref> This questionnaire is a self-report questionnaire that patients can rate difficulty and interference with daily life on a 5 point Likert scale.<ref name="dash" /><ref name="Beaton" />. The DASH has been translated in many different languages and has demonstrated to be a valid and reliable questionnaire for a variety of upper extremity disorders. <ref>Sigirtmac IC, Oksuz C. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8436820/ Systematic review of the quality of the cross-cultural adaptations of Disabilities of the Arm, Shoulder and Hand (DASH)]. La Medicina del Lavoro. 2021;112(4):279.</ref> | ||
The | |||
The ''Quick''DASH is an abbreviated version of the original DASH outcome measure. In comparison to the original 30 item DASH outcome measure, the ''Quick''DASH only contains 11 items<ref name="Gummesson" /> It is a questionnaire that measures an individual’s ability to complete tasks, absorb forces, and severity of symptoms<ref name="Gummesson">Gummesson C, Ward MM, Atroshi I. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1513569/ The shortened disabilities of the arm, shoulder and hand questionnaire (Quick DASH): validity and reliability based on responses within the full-length DASH]. BMC musculoskeletal disorders. 2006 Dec 1;7(1):44.</ref> The ''Quick''DASH tool uses a 5-point Likert scale from which the patient can select an appropriate number corresponding to his/her severity/function level.<ref name="Matheson">Matheson LN, Melhorn JM, Mayer TG, Theodore BR, Gatchel RJ. [https://pubmed.ncbi.nlm.nih.gov/16882902/ Reliability of a visual analog version of the QuickDASH.] JBJS. 2006 Aug 1;88(8):1782-7.</ref><br> | |||
== Intended Population == | == Intended Population == | ||
*The intended population for the DASH is any person with one or more upper extremity musculoskeletal disorders.<ref name="dash" /><ref name="Beaton" /><ref name="Beaton 2" /> | *The intended population for the DASH is any person with one or more upper extremity musculoskeletal disorders.<ref name="dash" /><ref name="Beaton" /><ref name="Beaton 2" /> | ||
*The ''Quick''DASH outcome measure is designed to be used on patients presenting with one or more disabilities of the arm, shoulder, and hand<ref name="Gummesson" /><ref name="Matheson" /> | *The ''Quick''DASH outcome measure is designed to be used on patients presenting with one or more disabilities of the arm, shoulder, and hand.<ref name="Gummesson" /><ref name="Matheson" /> | ||
=== Some examples of the DASH questions === | |||
How would you rate your ability to do the following tasks 1-5 (1 being no difficulty, 5 being unable): | |||
" Place an object on a shelf above your head" | |||
"Use a knife to cut food" | |||
"Wash your back" | |||
The latter part of the questionnaire rates your symptoms and impact on work and sport using a similar scale. | |||
The full [https://dash.iwh.on.ca/about-dash DASH is available here] | |||
The ''[https://dash.iwh.on.ca/about-quickdash Quick]''[https://dash.iwh.on.ca/about-quickdash DASH is available here] | |||
== Scoring == | == Scoring == | ||
| Line 22: | Line 36: | ||
DASH and ''Quick''DASH Scoring Formula = '''([(sum of ''n'' responses)/''n''] -1)(25)''' where ''n'' represents the number of completed items.<ref name="dash" /> | DASH and ''Quick''DASH Scoring Formula = '''([(sum of ''n'' responses)/''n''] -1)(25)''' where ''n'' represents the number of completed items.<ref name="dash" /> | ||
*DASH cannot be computed if greater than three items are missing.<ref name="dash" /> | *DASH cannot be computed if greater than <u>three</u> items are missing.<ref name="dash" /> | ||
*''Quick''DASH cannot be computed if greater than | *''Quick''DASH cannot be computed if greater than <u>one</u> item is missing.<ref name="dash" /> | ||
'''Level of Disability''' | '''Level of Disability''' | ||
| Line 29: | Line 43: | ||
''In both the DASH and ''Quick''DASH a higher scores indicate a greater level of disability and severity, whereas, lower scores indicate a lower level of disability.<ref name="dash" /><ref name="Beaton 2" /> The score on both test ranges from 0 (no disability) to 100 (most severe disability)<ref name="Gummesson" /><br> '' | ''In both the DASH and ''Quick''DASH a higher scores indicate a greater level of disability and severity, whereas, lower scores indicate a lower level of disability.<ref name="dash" /><ref name="Beaton 2" /> The score on both test ranges from 0 (no disability) to 100 (most severe disability)<ref name="Gummesson" /><br> '' | ||
= | == Additional Optional Modules == | ||
The DASH and ''Quick''DASH have two optional 4-item additional modules that can be used. The two optional additional modules are: | The DASH and ''Quick''DASH have two optional 4-item additional modules that can be used. The two optional additional modules are: | ||
*Work | *Work - Used for workman compensation patients or those whose disability is affecting their ability to work | ||
*Sports/Performing Arts | *Sports/Performing Arts - Used for Athletes and Musicians | ||
''The optional modules cannot be scored if an answer is missing.<ref name="dash" />''<br> | ''The optional modules cannot be scored if an answer is missing.<ref name="dash" />''<br> | ||
= Evidence | == Evidence == | ||
{| width="639" cellspacing="1" cellpadding="1" border="1" style="width: 639px; height: 183px;" | {| width="639" cellspacing="1" cellpadding="1" border="1" style="width: 639px; height: 183px;" | ||
| Line 51: | Line 63: | ||
| Reliability | | Reliability | ||
| ICC(2,1) = 0.96<ref name="Beaton" /> | | ICC(2,1) = 0.96<ref name="Beaton" /> | ||
| ICC(2,1) = 0.90<ref name="Mintken">Mintken | | ICC(2,1) = 0.90<ref name="Mintken">Mintken PE, Glynn P, Cleland JA. [https://pubmed.ncbi.nlm.nih.gov/19297202/ Psychometric properties of the shortened disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) and Numeric Pain Rating Scale in patients with shoulder pain.] Journal of Shoulder and Elbow Surgery. 2009 Nov 1;18(6):920-6.</ref> | ||
|- | |- | ||
| Validity | | Validity | ||
| Pearson r > 0.70<ref name="Beaton" /> | | Pearson r > 0.70<ref name="Beaton" /> | ||
| Pearson r > 0.70<ref name="Beaton 3" /> | | Pearson r > 0.70<ref name="Beaton 3">Beaton DE, Wright JG, Katz JN, [https://pubmed.ncbi.nlm.nih.gov/15866967/ Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of three item-reduction approaches]. JBJS. 2005 May 1;87(5):1038-46.</ref> | ||
|- | |- | ||
| Minimal Detectable Change (MDC) | | Minimal Detectable Change (MDC) | ||
| Line 62: | Line 74: | ||
|- | |- | ||
| Minimal Clinical Important Difference (MCID) | | Minimal Clinical Important Difference (MCID) | ||
| & | | 10.83-15<ref name=":0">Franchignoni F, Vercelli S, Giordano A, Sartorio F, Bravini E, Ferriero G. [https://www.jospt.org/doi/full/10.2519/jospt.2014.4893 Minimal clinically important difference of the disabilities of the arm, shoulder and hand outcome measure (DASH) and its shortened version (QuickDASH).] journal of orthopaedic & sports physical therapy. 2014 Jan;44(1):30-9.</ref> | ||
| | | 15.91-20<ref name=":0" /> | ||
|- | |||
|Responsiveness | |||
| | |||
*Good responsiveness to self-rated changes before and after most arm, shoulder, and hand diagnoses and surgeries<ref name="Beaton 2" /> | |||
*Comparable responsiveness compared to other joint and disease-specific measures<ref name="Beaton" /> | |||
|Slightly more responsive to the original DASH outcome measure and, clinically, may be preferable due to shorter length<ref name="Gummesson" /><ref name="Beaton 3" /> | |||
|- | |||
|Miscellaneous | |||
|Available in 27 different languages. | |||
Many of these versions have had or are in the process of being tested for their psychometric properties.<ref name="dash" /> | |||
|''Quick''DASH measure has more relative efficiency compared with the DASH<ref name="Beaton 3" /> Recent studies have also analyzed the reliability of a modified ''Quick''DASH outcome measure, from a questionnaire into a visual analog version<ref name="Matheson" /> | |||
|} | |} | ||
'''''(MDC)'''''<i>– the smallest amount of change that has to occur before the change can be considered a true change and not error<ref name="Beaton 2" /><br>'''(MCID)''' – the amount of change in the score that has to occur before it signifies an important or beneficial difference in the patient’s condition.</i>''<ref name="Mintken" / | '''''(MDC)'''''<i>– the smallest amount of change that has to occur before the change can be considered a true change and not error<ref name="Beaton 2" /><br>'''(MCID)''' – the amount of change in the score that has to occur before it signifies an important or beneficial difference in the patient’s condition.</i>''<ref name="Mintken" />'' | ||
== | == Resources == | ||
[https://www.orthopaedicscore.com/scorepages/disabilities_of_arm_shoulder_hand_score_dash.html Online version of DASH] | |||
[http://www.orthopaedicscore.com/scorepages/disabilities_of_arm_shoulder_hand_score_quickdash.html Online version of QuickDASH] | |||
== References == | == References == | ||
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<references /> | <references /> | ||
[[Category:Outcome_Measures]] [[Category:Shoulder]] [[Category:Hand]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Temple_Student_Project]] | [[Category:Outcome_Measures]] | ||
[[Category:Shoulder]] | |||
[[Category:Elbow]] | |||
[[Category:Wrist]] | |||
[[Category:Hand]] | |||
[[Category:Musculoskeletal/Orthopaedics]] | |||
[[Category:Temple_Student_Project]] | |||
[[Category:Occupational Health]] | [[Category:Occupational Health]] | ||
[[Category:Older People/Geriatrics]] | |||
[[Category:Older People/Geriatrics - Outcome Measures]] | |||
[[Category:Shoulder - Outcome Measures]] | |||
[[Category:Elbow - Outcome Measures]] | |||
[[Category:Wrist - Outcome Measures]] | |||
[[Category:Hand - Outcome Measures]] | |||
[[Category:Course Pages]] | |||
Latest revision as of 16:24, 11 November 2022
Original Editor - Nicole Wente as part of the Temple University EBP Project
Top Contributors - Nicole Wente, Admin, Kim Jackson, Abbey Wright, Rachael Lowe, Rucha Gadgil, Lauren Lopez, Scott A Burns, Laura Ritchie, Claire Knott, Robin Tacchetti, Tony Lowe, Evan Thomas, Scott Buxton and WikiSysop
Introduction[edit | edit source]
The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a 30-item questionnaire that looks at the ability of a patient to perform certain upper extremity activities.[1][2][3] This questionnaire is a self-report questionnaire that patients can rate difficulty and interference with daily life on a 5 point Likert scale.[1][2]. The DASH has been translated in many different languages and has demonstrated to be a valid and reliable questionnaire for a variety of upper extremity disorders. [4]
The QuickDASH is an abbreviated version of the original DASH outcome measure. In comparison to the original 30 item DASH outcome measure, the QuickDASH only contains 11 items[5] It is a questionnaire that measures an individual’s ability to complete tasks, absorb forces, and severity of symptoms[5] The QuickDASH tool uses a 5-point Likert scale from which the patient can select an appropriate number corresponding to his/her severity/function level.[6]
Intended Population[edit | edit source]
- The intended population for the DASH is any person with one or more upper extremity musculoskeletal disorders.[1][2][3]
- The QuickDASH outcome measure is designed to be used on patients presenting with one or more disabilities of the arm, shoulder, and hand.[5][6]
Some examples of the DASH questions[edit | edit source]
How would you rate your ability to do the following tasks 1-5 (1 being no difficulty, 5 being unable):
" Place an object on a shelf above your head"
"Use a knife to cut food"
"Wash your back"
The latter part of the questionnaire rates your symptoms and impact on work and sport using a similar scale.
The full DASH is available here
The QuickDASH is available here
Scoring [edit | edit source]
DASH and QuickDASH Scoring Formula = ([(sum of n responses)/n] -1)(25) where n represents the number of completed items.[1]
- DASH cannot be computed if greater than three items are missing.[1]
- QuickDASH cannot be computed if greater than one item is missing.[1]
Level of Disability
In both the DASH and QuickDASH a higher scores indicate a greater level of disability and severity, whereas, lower scores indicate a lower level of disability.[1][3] The score on both test ranges from 0 (no disability) to 100 (most severe disability)[5]
Additional Optional Modules[edit | edit source]
The DASH and QuickDASH have two optional 4-item additional modules that can be used. The two optional additional modules are:
- Work - Used for workman compensation patients or those whose disability is affecting their ability to work
- Sports/Performing Arts - Used for Athletes and Musicians
The optional modules cannot be scored if an answer is missing.[1]
Evidence[edit | edit source]
| Psychometric Property | DASH | QuickDASH |
| Reliability | ICC(2,1) = 0.96[2] | ICC(2,1) = 0.90[7] |
| Validity | Pearson r > 0.70[2] | Pearson r > 0.70[8] |
| Minimal Detectable Change (MDC) | 12.75% - 17.23%[3] | 11.2%[7] |
| Minimal Clinical Important Difference (MCID) | 10.83-15[9] | 15.91-20[9] |
| Responsiveness | Slightly more responsive to the original DASH outcome measure and, clinically, may be preferable due to shorter length[5][8] | |
| Miscellaneous | Available in 27 different languages.
Many of these versions have had or are in the process of being tested for their psychometric properties.[1] |
QuickDASH measure has more relative efficiency compared with the DASH[8] Recent studies have also analyzed the reliability of a modified QuickDASH outcome measure, from a questionnaire into a visual analog version[6] |
(MDC)– the smallest amount of change that has to occur before the change can be considered a true change and not error[3]
(MCID) – the amount of change in the score that has to occur before it signifies an important or beneficial difference in the patient’s condition.[7]
Resources[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 The DASH outcome measure. Available at http://www.dash.iwh.on.ca, Accessed March 12, 2011.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C. Measuring the whole or the parts?: validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. Journal of Hand Therapy. 2001 Apr 1;14(2):128-42.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Beaton DE, Davis AM, Hudak P, McConnell S. The DASH (Disabilities of the Arm, Shoulder and Hand) outcome measure: what do we know about it now?. The British Journal of Hand Therapy. 2001 Dec;6(4):109-18..
- ↑ Sigirtmac IC, Oksuz C. Systematic review of the quality of the cross-cultural adaptations of Disabilities of the Arm, Shoulder and Hand (DASH). La Medicina del Lavoro. 2021;112(4):279.
- ↑ 5.0 5.1 5.2 5.3 5.4 Gummesson C, Ward MM, Atroshi I. The shortened disabilities of the arm, shoulder and hand questionnaire (Quick DASH): validity and reliability based on responses within the full-length DASH. BMC musculoskeletal disorders. 2006 Dec 1;7(1):44.
- ↑ 6.0 6.1 6.2 Matheson LN, Melhorn JM, Mayer TG, Theodore BR, Gatchel RJ. Reliability of a visual analog version of the QuickDASH. JBJS. 2006 Aug 1;88(8):1782-7.
- ↑ 7.0 7.1 7.2 Mintken PE, Glynn P, Cleland JA. Psychometric properties of the shortened disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) and Numeric Pain Rating Scale in patients with shoulder pain. Journal of Shoulder and Elbow Surgery. 2009 Nov 1;18(6):920-6.
- ↑ 8.0 8.1 8.2 Beaton DE, Wright JG, Katz JN, Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of three item-reduction approaches. JBJS. 2005 May 1;87(5):1038-46.
- ↑ 9.0 9.1 Franchignoni F, Vercelli S, Giordano A, Sartorio F, Bravini E, Ferriero G. Minimal clinically important difference of the disabilities of the arm, shoulder and hand outcome measure (DASH) and its shortened version (QuickDASH). journal of orthopaedic & sports physical therapy. 2014 Jan;44(1):30-9.
