title: Predictive value of the DASH tool for predicting return to work of injured workers with musculoskeletal disorders of the upper extremity.
abstract: OBJECTIVE
  To determine whether the Disabilities of the Arm, Shoulder, and Hand (DASH) tool added to the predictive ability of established prognostic factors, including patient demographic and clinical outcomes, to predict return to work (RTW) in injured workers with musculoskeletal (MSK) disorders of the upper extremity.
  
  
  METHODS
  A retrospective cohort study using a population-based database from the Workers' Compensation Board of Alberta (WCB-Alberta) that focused on claimants with upper extremity injuries was used. Besides the DASH, potential predictors included demographic, occupational, clinical and health usage variables. Outcome was receipt of compensation benefits after 3 months. To identify RTW predictors, a purposeful logistic modelling strategy was used. A series of receiver operating curve analyses were performed to determine which model provided the best discriminative ability.
  
  
  RESULTS
  The sample included 3036 claimants with upper extremity injuries. The final model for predicting RTW included the total DASH score in addition to other established predictors. The area under the curve for this model was 0.77, which is interpreted as fair discrimination. This model was statistically significantly different than the model of established predictors alone (p<0.001). When comparing the DASH total score versus DASH item 23, a non-significant difference was obtained between the models (p=0.34).
  
  
  CONCLUSIONS
  The DASH tool together with other established predictors significantly helped predict RTW after 3 months in participants with upper extremity MSK disorders. An appealing result for clinicians and busy researchers is that DASH item 23 has equal predictive ability to the total DASH score.
authors: Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors: Susan
authors: S
authors: Armijo-Olivo
authors: Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.
authors: Linda J
authors: LJ
authors: Woodhouse
authors: Ted Rogers School of Management, Ryerson University, Toronto, Ontario, Canada.
authors: Ivan A
authors: IA
authors: Steenstra
authors: Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.
authors: Douglas P
authors: DP
authors: Gross
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000416:Alberta; D001134:Arm Injuries / Q000175:diagnosis / Q000628:therapy; D016208:Databases, Factual; D004185:Disability Evaluation; D005260:Female; D006230:Hand Injuries / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000628:therapy; D060051:Occupational Injuries / Q000175:diagnosis / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D062707:Return to Work; D012720:Severity of Illness Index; D000070599:Shoulder Injuries / Q000175:diagnosis / Q000628:therapy; D034941:Upper Extremity / Q000293:injuries; D014942:Workers' Compensation; D055815:Young Adult
keywords: Disabilities of the Arm, Shoulder, and Hand (DASH); Prognosis; Return to work; Upper extremity disorders