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. 2024 Jan 23;25(1):86.
doi: 10.1186/s12891-024-07183-w.

Concurrent validity study of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation

Joonas Pyörny  1 , Ida Neergård Sletten  2 , Jarkko Jokihaara  3   4
Affiliations

Concurrent validity study of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation

Joonas Pyörny et al. BMC Musculoskelet Disord. .

Abstract

Background: The Disability of the Arm, Shoulder and Hand Outcome Measure (DASH) is a validated patient-reported outcome measure (PROM) for many upper extremity musculoskeletal disorders. In patients with severe traumatic conditions, limited evidence exists regarding the equivalence between DASH and its shortened version, QuickDASH, which is more feasible in clinical practice. The rationale of this study was to analyze the concurrent validity of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation.

Methods: This study is based on a consecutive cohort of traumatic upper extremity amputation patients treated with replantation or revision (completion) amputation at Tampere University Hospital between 2009 and 2019. We estimated the concurrent validity of QuickDASH with respect to DASH by correlation coefficients, mean score differences, Bland-Altman plots, and distribution density. Additionally, we assessed internal reliability with Cronbach's alpha coefficients and item-total correlations.

Results: We found a very strong linear correlation between DASH and QuickDASH scores (r = 0.97 [CI 95% 0.97-0.98], p < 0.001). The mean difference between DASH and QuickDASH was minor (MD = -1, SD 4 [CI95% from -1 to 0] p = 0.02). The mean sub-score for the activity domain was higher for QuickDASH than DASH (MD = -3 [CI95% from -4 to -3] p < 0.000) and lower for the symptom domain (MD = 7 [CI95% from 6 to 9] p < 0.000). The Bland and Altman plot showed good agreement between DASH and QuickDASH scores, but there was measurement error in QuickDASH with high scores (r = -0.20, [CI95% from -0.31 to -0.09], p = 0.001).

Conclusion: QuickDASH demonstrates higher total scores than the full DASH and emphasizes rating of activity over symptoms. Still, on average the differences in total scores are likely less than the MCID of DASH, and consequently, this study shows that QuickDASH can be recommended instead of the full DASH when assessing a traumatic condition.

Trial registration: Retrospectively registered.

Keywords: Amputation; DASH; QuickDASH; Upper extremity.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Scatter plot between the DASH and QuickDASH total scores
Fig. 2
Fig. 2
Bland and Altman plot (difference plot) for agreement between DASH and QuickDASH scores
Fig. 3
Fig. 3
Density plots of (A) the DASH and (B) QuickDASH scores separated by injury level. Red color represents proximal to carpus injuries and blue represents distal to carpus injuries. A density plot visualizes the distribution of variables in terms of their density
See this image and copyright information in PMC

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