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Quick Disabilities of Arm, Shoulder & Hand

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Advocate Aurora Health Clinical Recommendations for Quick DASH

Purpose

The purpose of the QuickDASH is to use 11 items to measure physical function and symptoms in people with any or multiple musculoskeletal disorders of the upper limb. The QuickDASH is a widely used reference of self reported disability. The QuickDASH decreases responder and data entry burden while maintaining a high degree of correlation to the original length DASH.

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Instrument Details

Acronym QuickDASH

Area of Assessment

Activities of Daily Living
Communication
Coordination
Dexterity
Eating
Functional Mobility
General Health
Life Participation
Occupational Performance
Pain
Quality of Life
Sleep
Social Relationships
Social Support
Strength
Upper Extremity Function

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Arthritis + Joint Conditions
  • Pain Management

Populations

Musculoskeletal Conditions
Non-Specific Patient Population
Chronic Pain

Key Descriptions

  • 11 items from the full length DASH were extracted to constitute the QuickDASH.
  • To calculate a QuickDASH score, at least 10 of the 11 items must be completed.
  • Similar to the DASH, each item has 5 response options and, from the item scores, scale scores are calculated, ranging from 0 (no disability) to 100 (most severe disability).

Number of Items

11

Equipment Required

  • Pencil or paper
  • Copy of outcome measure

Time to Administer

10 minutes

Required Training

No Training

Age Ranges

Adolescent

13 - 17

years

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by Kim Kurtz, SPT Lindsay Braun, SPT Julie Canfield, SPT Drew Grant, SPT Sean Husted, SPT Becca Todd, SPT Christine Ulses, SPT Mitch Therriault, SPT and Jen Tier, SPT in 5/2014

Body Part

Neck
Upper Extremity

ICF Domain

Activity
Participation

Measurement Domain

Activities of Daily Living
Sensory

Considerations

According to Franchignoni (2011), it is recommended that future studies consider revising the QuickDASH.

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

 

Musculoskeletal Conditions

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Standard Error of Measurement (SEM)

Upper Extremity Musculoskeletal Disorders

  • Gabel (2009; n=137; mean age=48.4(15.6) years; with clinician referral): SEM=7.38

Minimal Detectable Change (MDC)

Upper Extremity Musculoskeletal Disorders

  • Gabel (2009): MDC=17.18 

  • Polson (2010; n=35; mean age=48.7(15.7) years): MDC=11

Minimally Clinically Important Difference (MCID)

Neck & Upper Extremity Musculoskeletal Disorders

  • Fan (2008; n=231; mean age=39.5(0.5) years; clinical diagnosis or symptoms present): MCID=10 

 

Upper Extremity Musculoskeletal Disorders

  • Polson (2010): MCID=9.0-11.3

Test/Retest Reliability

Upper Extremity Musculoskeletal Disorders

  • Gabel (2009): Excellent test-retest reliability (ICC=0.94) 

  • Polson (2010): Excellent test-retest reliability (ICC=0.94) 

  • Gummesson (2006; n=105; mean age=52; symptoms more than 2 months): Excellent test-retest reliability (ICC=0.93) 

  • Franchignoni (2011; n=283; mean age=52.3(15.9) years): Excellent item separation reliability (ICC=0.99)

 

Shoulder, Elbow & Wrist Arthroplasty Patients

  • Angst (2009; n=320): Excellent test-retest reliability (ICC=0.93) 

 

Common Shoulder Conditions

  • Fayad (2009; n=153; mean age=57): Excellenttest-retest reliability (ICC=0.94)

Internal Consistency

Upper Extremity Musculoskeletal Disorders

  • Gummesson (2006): Excellent internal consistency (Chronbach alpha=0.92) 

  • Franchignoni (2011): Good internal consistency (Chronbach alpha=0.87)

 

Shoulder, Elbow & Wrist Arthroplasty Patients

  • Angst (2009): Excellent internal consistency (Cronbach alpha=0.92 

 

Common Shoulder Conditions

  • Fayad (2009): Good internal consistency (Chronbach alpha=0.89)

Criterion Validity (Predictive/Concurrent)

Neck & Upper Extremity Musculoskeletal Disorders Fan (2008)

  • Moderate correlation with PCS-12 (r=-0.44)

 

Neck & Upper Extremity Musculoskeletal DisordersFan (2008) 

  • Moderate correlation with PCS-12 (r=-0.44)

Construct Validity

Upper Extremity Musculoskeletal DisordersGummesson (2006) 

  • For the patients who rated their arm status after surgery as better (“much better” and “somewhat better”) and as “unchanged,” the difference in area under ROC curves for DASH & QuickDASH=0.01, indicating excellent convergent validity with the DASH, as there is no ability to discriminate a difference between the 2 groups. In the ROC analysis comparing the ability to discriminate “much better” from “somewhat better,” the difference in the area under the ROC curves was 0.03, also indicating excellent convergent validity. 

Gabel (2009) 

  • Construct validity was demonstrated by a standard t-test that verified change between the baseline and the repeated measures.

 

Shoulder, Elbow & Wrist Arthroplasty Patients Angst (2009) 

  • The higher the effect size, the more sensitive (responsive) is a scale and a more sensitive scale requires more specific item questions. In this sense, the responsiveness is also a measure of the instrument’s specificity and is considered to be a form of construct validity. ES: QuickDASH/DASH= 1.42/1.65.

Content Validity

Upper Extremity Musculoskeletal Disorders

  • Gabel (2009): Determined from development studies and QuickDASH, supported in study by the practicality focus group.

 

Common Shoulder Conditions

  • Fayad (2009): The F-QuickDASH-D/S scale had excellent correlation with the full-length F-DASH-D/S score (r=0.96). 
  • Franchignoni (2011): A Rasch analysis was performed, which showed that 10 of the 11 QuickDASH items fitted the Rasch model (MnSq between 0.7 and 1.3).

Face Validity

Upper Extremity Musculoskeletal Disorders:

  • Gabel (2009): Determined from development studies and QuickDASH, supported in study by the practicality focus group.

Floor/Ceiling Effects

Common Shoulder Conditions

  • Fayad (2009): No item had a floor or ceiling effect.

Responsiveness

Neck & Upper Extremity Musculoskeletal Disorders

  • Fan (2011): High responsiveness (ES=1.3; SRM=1.0) 

 

Upper Extremity Musculoskeletal Disorders

  • Gabel (2009): High responsiveness (ES=1.05) 

  • Polson (2010): High responsiveness (ES=1.02; SRM=1.1) 

  • Gummesson (2006): Moderate responsiveness (ES=0.5; SRM=0.63)

 

Shoulder, Elbow & Wrist Arthroplasty Patients

  • Angst (2009): High responsiveness (ES: QuickDASH/DASH=1.42/1.65) 

 

Common Shoulder Conditions

  • Fayad (2009): High responsiveness (ES=1.23; SRM=1.09)

Chronic Pain

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Standard Error of Measurement (SEM)

Shoulder Pain

  • Mintken (2009; n=101; mean age=40.3(18.5) years): SEM=4.8

Minimal Detectable Change (MDC)

Shoulder Pain

  • Mintken (2009): MDC=11.2

Minimally Clinically Important Difference (MCID)

Shoulder Pain

  • Mintken (2009): MCID=8

Test/Retest Reliability

Shoulder Pain

  • Mintken (2009): Excellent test-retest reliability (ICC=0.90)

Internal Consistency

Shoulder Pain

  • Mintken (2009): Excellent internal consistency (Chronbach alpha=0.92)

Criterion Validity (Predictive/Concurrent)

Shoulder Pain Mintken (2009) 

  • Excellent correlation with DASH (r=0.98) 

 

Neck Pain Mehta (2010, n=66; mean age=40.6(14.2) years) 

  • Excellent correlation with DASH (r=0.97) 

  • High correlation with NDI (r=0.82) 

  • Moderate correlation with VAS (r=0.64) 

  • Moderate correlation with CSOQ subscales: neck pain (r=0.65); shoulder & arm pain (r=0.57); physical symptom (r=0.68); functional disability (0.59); psychological distress (r=0.58)

Construct Validity

Shoulder Pain Mintken (2009) 

  • Examined by comparing the baseline and follow-up scores of both the stable and improved groups. Significantly greater reductions in disability among patients rating themselves as improved versus stable. There was a significant interaction between groups for the pretest and post-test scores, indicating that the change in QuickDASH with time differed between stable and improved patients.

Content Validity

Shoulder Pain

  • Mintken (2009): Since its development, it has been cross-culturally adapted and validated in over 20 languages

Floor/Ceiling Effects

Neck Pain

  • Mehta (2010): The histogram for the QuickDASH had a normal distribution, indicating no floor or ceiling effects.

Responsiveness

Shoulder Pain

  • Mintken (2009): High responsiveness (ES=0.82)

Non-Specific Patient Population

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Minimally Clinically Important Difference (MCID)

Outpatient Hand Clinic Patients

  • London (2014; n=50; mean age=53(17) years): MCID=8-15

Test/Retest Reliability

Pathologies of Outpatient Hand Clinic Patients

  • London (2014): Adequate test-retest reliability (ICC=0.68)

Bibliography

Angst, F., J. Goldhahn, et al. (2009). "How sharp is the short QuickDASH? A refined content and validity analysis of the short form of the disabilities of the shoulder, arm and hand questionnaire in the strata of symptoms and function and specific joint conditions." Quality of Life 嫩B研究院 18(8): 1043-1051. 

Angst, F., H. K. Schwyzer, et al. (2011). "Measures of adult shoulder function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and its short version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society standardized shoulder assessment form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI)." Arthritis care & research 63(S11): S174-S188. 

Beaton, D., C. Bombardier, et al. (2007). "Recommendations for the cross-cultural adaptation of the DASH & QuickDASH outcome measures." Institute for Work & Health 1(1): 1-45. 

Beaton, D. E., J. G. Wright, et al. (2005). "Development of the QuickDASH: comparison of three item-reduction approaches." The Journal of Bone & Joint Surgery 87(5): 1038-1046. 

Fan, Z. J., C. K. Smith, et al. (2008). "Assessing Validity of the< i> Quick DASH and SF-12 as Surveillance Tools among Workers with Neck or Upper Extremity Musculoskeletal Disorders." Journal of Hand Therapy 21(4): 354-365. 

Fan, Z. J., C. K. Smith, et al. (2011). "Responsiveness of the QuickDASH and SF-12 in workers with neck or upper extremity musculoskeletal disorders: one-year follow-up." Journal of occupational rehabilitation 21(2): 234-243. 

Fayad, F., M.-M. Lefevre-Colau, et al. (2009). "Reliability, validity and responsiveness of the French version of the questionnaire Quick Disability of the Arm, Shoulder and Hand in shoulder disorders." Manual therapy 14(2): 206-212. 

Franchignoni, F., G. Ferriero, et al. (2011). "Psychometric properties of QuickDASH–A classical test theory and Rasch analysis study." Manual therapy 16(2): 177-182. 

Gabel, C. P., M. Yelland, et al. (2009). "A modified QuickDASH-9 provides a valid outcome instrument for upper limb function." BMC musculoskeletal disorders 10(1): 161. 

Gummesson, C., M. M. Ward, et al. (2006). "The shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH): validity and reliability based on responses within the full-length DASH." BMC Musculoskeletal Disorders 7(1): 44. 

Haas, F., M. Hubmer, et al. (2011). "Long-term subjective and functional evaluation after thumb replantation with special attention to the Quick DASH questionnaire and a specially designed trauma score called modified mayo score." Journal of Trauma-Injury, Infection, and Critical Care 71(2): 460-466. 

Kennedy, C., D. Beaton, et al. (2001). "The DASH and Quick DASH Outcome Measure's Manual." 

Kennedy, C., D. Beaton, et al. (2001). "The DASH and Quick DASH Outcome Measure's Manual Institute for Work & Health." Toronto, Ontario. 

London, D. A., J. G. Stepan, et al. (2014). "Performance characteristics of the verbal QuickDASH." J Hand Surg Am 39(1): 100-107. 

Mardani-Kivi, M., M. Karimi-Mobarakeh, et al. (2013). “The effects of corticosteroid injection versus local anesthetic injection in the treatment of lateral epicondylitis: a randomized single-blinded clinical trial.” Archives of Orthopaedic and Trauma Surgery 133(6): 757-763. 

Matheson, L. N., J. M. Melhorn, et al. (2006). "Reliability of a visual analog version of the QuickDASH." The Journal of Bone & Joint Surgery 88(8): 1782-1787. 

Mehta, S., J. C. MacDermid, et al. (2010). "Concurrent validation of the DASH and the QuickDASH in comparison to neck-specific scales in patients with neck pain." Spine 35(24): 2150-2156. 

Mintken, P. E., P. Glynn, et al. (2009). "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 18(6): 920-926. 

Nakamoto, H., Y. Oshima, et al. (2014). "Usefulness of QuickDASH in patients with cervical laminoplasty." J Orthop Sci 19(2): 218-222. 

Niekel, M. C., A. L. Lindenhovius, et al. (2009). "Correlation of DASH and QuickDASH with measures of psychological distress." The Journal of hand surgery 34(8): 1499-1505. 

Polson, K., D. Reid, et al. (2010). "Responsiveness, minimal importance difference and minimal detectable change scores of the shortened disability arm shoulder hand (QuickDASH) questionnaire." Manual therapy 15(4): 404-407. 

Quatman-Yates, C. C., R. Gupta, et al. (2013). "Internal consistency and validity of the QuickDASH instrument for upper extremity injuries in older children." J Pediatr Orthop 33(8): 838-842. 

Stepan, J. G., D. A. London, et al. (2013). "Accuracy of patient recall of hand and elbow disability on the QuickDASH questionnaire over a two-year period." J Bone Joint Surg Am 95(22): e176.

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