TY - JOUR
T1 - Minimal clinically important difference of the disabilities of the arm, shoulder and hand outcome measure (DASH) and its shortened version (quickDASH)
AU - Franchignoni, Franco
AU - Vercelli, Stefano
AU - Giordano, Andrea
AU - Sartorio, Francesco
AU - Bravini, Elisabetta
AU - Ferriero, Giorgio
PY - 2014
Y1 - 2014
N2 - 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 adminis- Tered 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.
AB - 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 adminis- Tered 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.
KW - Disability evaluation
KW - Musculoskeletal diseases
KW - Outcome assessment
KW - Psycho-metrics
KW - Rehabilitation
KW - Upper extremity
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U2 - 10.2519/jospt.2014.4893
DO - 10.2519/jospt.2014.4893
M3 - Article
C2 - 24175606
AN - SCOPUS:84904008380
VL - 44
SP - 30
EP - 39
JO - Journal of Orthopaedic and Sports Physical Therapy
JF - Journal of Orthopaedic and Sports Physical Therapy
SN - 0190-6011
IS - 1
ER -