Minimal Clinically Important Difference of the Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH) and Its Shortened Version (QuickDASH)

被引:563
作者
Franchignoni, Franco [1 ]
Vercelli, Stefano [1 ]
Giordano, Andrea [2 ]
Sartorio, Francesco [1 ]
Bravini, Elisabetta [3 ]
Ferriero, Giorgio [1 ]
机构
[1] Fdn Salvatore Maugeri, IRCCS, Unit Occupat Rehabil & Ergon, I-28010 Veruno, NO, Italy
[2] Fdn Salvatore Maugeri, IRCCS, Unit Bioengn, I-28010 Veruno, NO, Italy
[3] Univ Roma Tor Vergata, PhD Program Adv Sci & Technol Rehabil Med & Sport, Rome, Italy
关键词
disability evaluation; musculoskeletal diseases; outcome assessment; psychometrics; rehabilitation; upper extremity; HEALTH-STATUS MEASURES; DETECTABLE CHANGE; QUESTIONNAIRES; RESPONSIVENESS; INDEX; INSTRUMENTS; VALIDATION; PRECISION; SURGERY; SCORES;
D O I
10.2519/jospt.2014.4893
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
STUDY DESIGN: Prospective, single-group observational design. OBJECTIVES: To determine the minimal clinically important difference (MCID) for the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure and its shortened version (QuickDASH) in patients with upper-limb musculoskeletal disorders, using a triangulation of distribution- and anchor-based approaches. BACKGROUND: Meaningful threshold change values of outcome tools are crucial for the clinical decision-making process. METHODS: The DASH and QuickDASH were administered to 255 patients (mean +/- SD age, 49 +/- 15 years; 156 women) before and after a physical therapy program. The external anchor administered after the program was a 7-point global rating of change scale. RESULTS: The test-retest reliability of the DASH and QuickDASH was high (intraclass correlation coefficient model 2,1 = 0.93 and 0.91, respectively; n = 30). The minimum detectable change at the 90% confidence level was 10.81 points for the DASH and 12.85 points for the QuickDASH. After triangulation of these results with those of the mean-change approach and receiver-operating characteristic-curve analysis, the following MCID values were selected: 10.83 points for the DASH (sensitivity, 82%; specificity, 74%) and 15.91 points for the QuickDASH-(sensitivity, 79%; specificity, 75%). After treatment, the MCID threshold was reached/surpassed by-61% of subjects using the DASH and 57% using the QuickDASH. CONCLUSION: The MCID values from this study for the DASH (10.83 points) and the QuickDASH (15.91 points) could represent the lower boundary for a range of MCID values (reasonably useful for different populations and contextual characteristics). The upper boundary may be represented by the 15 points for the DASH and 20 points for the QuickDASH proposed by the DASH website.
引用
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页码:30 / 39
页数:10
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