title: A scoping review of disabilities of the arm, shoulder, and hand scores for hand and wrist conditions.
abstract: OBJECTIVE
  To evaluate the variability of reported baseline Disabilities of the Arm, Shoulder, and Hand (DASH) scores for non-acute hand and wrist conditions. We hypothesized that DASH scores for evaluation of hand and wrist pathology would provide a map of scores that would correspond to severity. In addition to providing a catalog of DASH scores for various upper extremity pathologies, we hypothesized that this review would support the validity of the DASH instrument.
  
  
  METHODS
  A literature search was performed using 3 databases (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials) from the earliest available date through January 1, 2013. Search terms included "DASH" and "hand" and combinations of conditions found in the initial search. The search was restricted to studies with baseline DASH scores and DASH scores for isolated conditions, and written in the English language.
  
  
  RESULTS
  Our search identified 1,770 citations; 136 full-text articles were reviewed and 85 studies were included in the scoping review. This provided 100 DASH scores mapped for 24 different diagnoses. Most articles (67%) included chronic conditions for inflammatory or degenerative pathologies rather than posttraumatic disorders. Posttraumatic DASH score reporting ranged from 4 months to 11 years after injury, and final outcome scores varied among studies assessing the same pathology. The greatest variation and highest scores were for de Quervain tendinitis (range, 29-93) and scapholunate advance collapse (range, 17-89). These scores indicated higher disability in de Quervain tendinitis and wrist osteoarthritis compared with conditions such as thumb amputation and upper extremity replantation.
  
  
  CONCLUSIONS
  Substantial variation in the DASH scores and methodology was found and indicates a need for further study of the DASH to allow for standardized interpretation.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: University of Toronto Hand and Upper Extremity Program, Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Baltzer
authors.affiliation: University of Toronto Hand and Upper Extremity Program, Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Christine B
authors.initials: CB
authors.lastname: Novak
authors.affiliation: University of Toronto Hand and Upper Extremity Program, Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, Ontario, Canada. Electronic address: steve.mccabe@uhn.ca.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: McCabe
mesh_terms: D004185:Disability Evaluation; D006801:Humans; D012720:Severity of Illness Index; D034941:Upper Extremity / Q000503:physiopathology*
keywords: DASH scores; Outcomes; scoping review