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.
OBJECTIVE
To assess and compare content, validity, and specificity of the QuickDASH (Disability of the arm, shoulder and hand questionnaire) as compared to the full-length DASH and other instruments to give a recommendation for its use depending on a specific clinical situation.


METHODS
Data of three large cohorts of patients with shoulder (n = 138), elbow (n = 79), and carpo-metacarpal I (n = 103) arthroplasties were analyzed. The item content of both instruments was compared within the subdomains function and symptoms. Scores and correlations to other instruments were compared in all strata to assess construct convergence. Specificity was quantified and compared using receiver operating characteristics curves (ROC) and effect sizes (in shoulder only).


RESULTS
The QuickDASH underestimates symptoms (e.g., 71.1 vs. DASH 66.1 in elbow, 100 = no symptoms, P < 0.001) but overestimates disability (e.g., 72.8 vs. DASH 78.5 in wrist, 100 = full function, P < 0.001). It does not measure the same content as the DASH although the total score levels of both instruments are similar. Furthermore, the QuickDASH is less specific than the DASH in the subdomains, especially in symptoms: for example, area under ROC 0.65 vs. DASH 0.68 in elbow (P = 0.015); effect size in shoulder 1.42 vs. DASH 1.65 (P < 0.001).


CONCLUSIONS
The short QuickDASH can be recommended for a summary assessment of arm symptoms and function based on the total score in the daily clinical rush. For differentiated assessment of symptoms and function, e.g. for clinical studies, the full-length DASH provides more specific and sophisticated results.
Angst
Felix
F
Department of Upper Extremity and Hand Surgery, Schulthess Klinik, Lengghalde 2, 8008, Zurich, Switzerland. fangst@vtxmail.ch
Goldhahn
Jörg
J
Drerup
Susann
S
Flury
Matthias
M
Schwyzer
Hans-Kaspar
HK
Simmen
Beat R
BR
D001134:Arm Injuries; D015331:Cohort Studies; D004185:Disability Evaluation; D006230:Hand Injuries; D006801:Humans; D008137:Longitudinal Studies; D011594:Psychometrics; D011788:Quality of Life; D012372:ROC Curve; D015203:Reproducibility of Results; D000070599:Shoulder Injuries; D013223:Statistics as Topic; D011795:Surveys and Questionnaires
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