title: Cross-cultural adaptation of the disabilities of the arm, shoulder, and hand (DASH) questionnaire into Hungarian and investigation of its validity in patients with systemic sclerosis.
abstract: OBJECTIVE
  To adapt and validate the Hungarian version of the DASH and the shorter QuickDASH Outcome Measures and to establish their validity in patients with systemic sclerosis (SSc).
  
  
  METHODS
  The Hungarian adaptation of the questionnaires was performed using forward/backward translations, expert and lay reviews. 128 patients completed the DASH, the Health Assessment Questionnaire (HAQ-DI), the Modified HAQ-DI for patients with SSc (SSc-HAQ), and the Short Form Health Survey (SF-36) questionnaire. 76 patients participated in a 12-month follow-up examination. Sensitivity to change was estimated using the standardized response mean (SRM).
  
  
  RESULTS
  Cronbach alpha in the DASH sections were between 0.94-0.97. The intraclass correlation coefficient for the test-retest reliability of DASH was 0.89. DASH scores showed a correlation with both SSc-HAQ and the physical dimensions of the SF-36 (Spearman's rho: 0.89, -0.77 and -0.42, respectively). The SRM of DASH was 0.64 among the scleroderma patients with worsening HAQ-DI status.
  
  
  CONCLUSIONS
  The Hungarian version of the DASH and QuickDASH demonstrated equivalent reproducibility, internal consistency and validity to the originals. The strong correlations of the DASH and QuickDASH with the HAQ-DI, and with the physical dimensions of the SF-36 show that the disability of the patient with SSc is predominantly caused by the functional impairment of the upper limb. Because both questionnaires were valuable tools for measuring upper extremity function and joint damage in SSc patients, we recommend the shorter and simpler QuickDASH for everyday clinical use.
authors.affiliation: Department of Immunology and Rheumatology, Faculty of Medicine, University of Pécs, Pécs, Hungary. cecilia.varju@aok.pte.hu
authors.forename: C
authors.initials: C
authors.lastname: Varjú
authors.forename: Z
authors.initials: Z
authors.lastname: Bálint
authors.forename: A I
authors.initials: AI
authors.lastname: Solyom
authors.forename: H
authors.initials: H
authors.lastname: Farkas
authors.forename: E
authors.initials: E
authors.lastname: Kárpáti
authors.forename: B
authors.initials: B
authors.lastname: Berta
authors.forename: G
authors.initials: G
authors.lastname: Kumánovics
authors.forename: L
authors.initials: L
authors.lastname: Czirják
authors.forename: Z
authors.initials: Z
authors.lastname: Nagy
mesh_terms: D000368:Aged; D054521:Cultural Competency; D018450:Disease Progression; D005260:Female; D006801:Humans; D006814:Hungary; D008297:Male; D008875:Middle Aged; D012594:Scleroderma, Localized / Q000175:diagnosis*; D012595:Scleroderma, Systemic / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D034941:Upper Extremity / Q000503:physiopathology*