DASH Outcome Measure: Difference between revisions
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'''Original Editor '''- [[User:Nicole Wente|Nicole Wente]] as part of the [[Temple University Evidence-Based Practice Project|Temple University EBP Project]] | '''Original Editor '''- [[User:Nicole Wente|Nicole Wente]] as part of the [[Temple University Evidence-Based Practice Project|Temple University EBP Project]] | ||
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | |||
</div> | </div> | ||
== Summary == | == Summary == | ||
[[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. | 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 D.E., Katz J.N., Fossel A. H., Wright J.G., 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. J Hand Ther. 2001; 14(2): 128-146.</ref><ref name="Beaton 2">Beaton D.E., Davis A.M., Hudak P., McConnell S. The DASH (Disabilities of the Arm, Shoulder and Hand) outcome measure: What do we know about it now? British Journal of Hand Therapy. 2001; 6(4): 109-118.</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 ''Quick''DASH is an abbreviated version of the original DASH outcome measure<ref name="Gummesson" /> 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 M.M., 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; 7(44): 1-7.</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 level/ function level<ref name="Matheson">Matheson L.N., Melhorn M., Mayer T.G., Theodore B.R., Gatchel R.J. Reliability of a visual analog version of the Quick DASH. J Bone Joint Surg Am. 2006; 88: 1782-1787.</ref><br> | |||
== Intended Population == | == Intended Population == | ||
*The intended population for the DASH is any person with one or more upper extremity musculoskeletal disorders. | *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" / | *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" /> | ||
== Scoring == | == Scoring == | ||
DASH and ''Quick''DASH Scoring Formula = '''([(sum of ''n'' responses)/''n''] -1)(25)''' where ''n'' represents the number of completed items | 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. | *DASH cannot be computed if greater than three items are missing.<ref name="dash" /> | ||
*''Quick''DASH cannot be computed if greater than 1 item is missing. | *''Quick''DASH cannot be computed if greater than 1 item is missing.<ref name="dash" /> | ||
'''Level of Disability''' | '''Level of Disability''' | ||
''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. | ''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> '' | ||
= Additonal Optional Modules = | = Additonal 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:<ref name="dash" /> | ||
*Work Module - Used for workman compensation patients or those whose disability is affecting their ability to work | *Work Module - Used for workman compensation patients or those whose disability is affecting their ability to work | ||
| Line 36: | Line 37: | ||
*Sports/Performing Arts Module - Used for Athletes and Musicians | *Sports/Performing Arts Module - Used for Athletes and Musicians | ||
''The optional modules cannot be scored if an answer is missing. | ''The optional modules cannot be scored if an answer is missing.<ref name="dash" />''<br> | ||
= Evidence = | = Evidence = | ||
| Line 49: | Line 50: | ||
|- | |- | ||
| Reliability | | Reliability | ||
| ICC(2,1) = 0.96 | | ICC(2,1) = 0.96<ref name="Beaton" /> | ||
| ICC(2,1) = 0.90 | | ICC(2,1) = 0.90<ref name="Mintken">Mintken P.E., Glynn P., Cleland J.A. Psychometric properties of the shortened disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) and Numeric Pain Rating Scale in patients with shoulder pain. J Shoulder Elbow Surg. 2009; 18(6): 920-926.</ref> | ||
|- | |- | ||
| Validity | | Validity | ||
| Pearson r > 0.70 | | Pearson r > 0.70<ref name="Beaton" /> | ||
| Pearson r > 0.70 | | Pearson r > 0.70<ref name="Beaton 3" /> | ||
|- | |- | ||
| Minimal Detectable Change (MDC) | | Minimal Detectable Change (MDC) | ||
| 12.75% - 17.23% | | 12.75% - 17.23%<ref name="Beaton 2" /> | ||
| 11.2% | | 11.2%<ref name="Mintken" /> | ||
|- | |- | ||
| Minimal Clinical Important Difference (MCID) | | Minimal Clinical Important Difference (MCID) | ||
| -------- | | -------- | ||
| 8% | | 8%<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" / | '''''(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" /><br>'' | ||
==== Responsiveness ==== | ==== Responsiveness ==== | ||
*DASH | *DASH | ||
**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" /> | |||
*''Quick''DASH | *''Quick''DASH | ||
**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">Beaton D.E., Wright J., Katz J.N. Development of the Quick DASH: comparison of the three item-reduction approaches. J Bone Joint Surg Am. 2005; 87: 1038-1046.</ref> | |||
==== Miscellaneous ==== | ==== Miscellaneous ==== | ||
*The DASH is available in 27 different languages. | *The DASH is available in 27 different languages.<ref name="dash" /> Also many of these versions have had or are in the process of being tested for their psychometric properties.<ref name="dash" /> | ||
*The ''Quick''DASH measure has more relative efficiency compared with the DASH<ref name="Beaton 3" / | *The ''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" /><br> | ||
== References == | == References == | ||
<references / | <references /> | ||
[[Category:Outcome_Measures]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Temple_Student_Project]] | [[Category:Outcome_Measures]] [[Category:Shoulder]] [[Category:Hand]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Temple_Student_Project]] | ||
Revision as of 21:13, 2 November 2017
Original Editor - Nicole Wente as part of the Temple University EBP Project
Top Contributors - Nicole Wente, Admin, Rachael Lowe, Kim Jackson, Abbey Wright, Lauren Lopez, Scott A Burns, Laura Ritchie, Rucha Gadgil, Robin Tacchetti, Tony Lowe, Evan Thomas, Scott Buxton, WikiSysop and Claire Knott
Summary[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 QuickDASH is an abbreviated version of the original DASH outcome measure[4] In comparison to the original 30 item DASH outcome measure, the QuickDASH only contains 11 items[4] It is a questionnaire that measures an individual’s ability to complete tasks, absorb forces, and severity of symptoms[4] The QuickDASH tool uses a 5-point Likert scale from which the patient can select an appropriate number corresponding to his/her severity level/ function level[5]
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[4][5]
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 1 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)[4]
Additonal 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:[1]
- Work Module - Used for workman compensation patients or those whose disability is affecting their ability to work
- Sports/Performing Arts Module - Used for Athletes and Musicians
The optional modules cannot be scored if an answer is missing.[1]
Evidence[edit | edit source]
Table[edit | edit source]
| Psychometric Property | DASH | QuickDASH |
| Reliability | ICC(2,1) = 0.96[2] | ICC(2,1) = 0.90[6] |
| Validity | Pearson r > 0.70[2] | Pearson r > 0.70[7] |
| Minimal Detectable Change (MDC) | 12.75% - 17.23%[3] | 11.2%[6] |
| Minimal Clinical Important Difference (MCID) | -------- | 8%[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.[6]
Responsiveness[edit | edit source]
- DASH
- QuickDASH
Miscellaneous[edit | edit source]
- The DASH is available in 27 different languages.[1] Also many of these versions have had or are in the process of being tested for their psychometric properties.[1]
- The QuickDASH measure has more relative efficiency compared with the DASH[7] Recent studies have also analyzed the reliability of a modified QuickDASH outcome measure, from a questionnaire into a visual analog version[5]
References[edit | edit source]
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 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 D.E., Katz J.N., Fossel A. H., Wright J.G., 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. J Hand Ther. 2001; 14(2): 128-146.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Beaton D.E., Davis A.M., Hudak P., McConnell S. The DASH (Disabilities of the Arm, Shoulder and Hand) outcome measure: What do we know about it now? British Journal of Hand Therapy. 2001; 6(4): 109-118.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Gummesson C., Ward M.M., 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; 7(44): 1-7.
- ↑ 5.0 5.1 5.2 Matheson L.N., Melhorn M., Mayer T.G., Theodore B.R., Gatchel R.J. Reliability of a visual analog version of the Quick DASH. J Bone Joint Surg Am. 2006; 88: 1782-1787.
- ↑ 6.0 6.1 6.2 6.3 Mintken P.E., Glynn P., Cleland J.A. Psychometric properties of the shortened disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) and Numeric Pain Rating Scale in patients with shoulder pain. J Shoulder Elbow Surg. 2009; 18(6): 920-926.
- ↑ 7.0 7.1 7.2 Beaton D.E., Wright J., Katz J.N. Development of the Quick DASH: comparison of the three item-reduction approaches. J Bone Joint Surg Am. 2005; 87: 1038-1046.
