title: The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: reliability and validity of the Swedish version evaluated in 176 patients.
abstract: The disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered region-specific outcome instrument developed to measure upper-extremity disability and symptoms. The DASH consists mainly of a 30-item disability/symptom scale. We performed cross-cultural adaptation of the DASH to Swedish, using a process that included double forward and backward translations, expert and lay review, as well as field-testing to achieve linguistic and conceptual equivalence. The Swedish version's reliability and validity were then evaluated in 176 patients with upper-extremity conditions. The patients completed the DASH and SF-12 generic health questionnaire before elective surgery or physical therapy. Internal consistency of the DASH was high (Cronbach alpha 0.96). Test-retest reliability, evaluated in a subgroup of 67 patients who completed the DASH on two occasions, with a median interval of 7 days, was excellent (intraclass correlation coefficient 0.92). Construct validity was shown by a positive correlation of DASH scores with the SF-12 scores (worse upper-extremity disability correlating with worse general health), stronger correlation with the SF-12 physical than with the mental health component, correlation of worse DASH scores with worse self-rated global health, and ability to discriminate among conditions known to differ in severity. The Swedish version of the DASH is a reliable and valid instrument that can provide a standardized measure of patient-centered outcomes in upper-extremity musculoskeletal conditions.
authors.affiliation: Department or Orthopedics, Hässleholm-Kristianstad Hospitals, Sweden. isam.atroshi@mailbox.swipnet.se
authors.forename: I
authors.initials: I
authors.lastname: Atroshi
authors.forename: C
authors.initials: C
authors.lastname: Gummesson
authors.forename: B
authors.initials: B
authors.lastname: Andersson
authors.forename: E
authors.initials: E
authors.lastname: Dahlgren
authors.forename: A
authors.initials: A
authors.lastname: Johansson
mesh_terms: D003431:Cross-Cultural Comparison; D006305:Health Status Indicators; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D015203:Reproducibility of Results; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013548:Sweden