Abstract
This study determined which upper limb regional patient report outcome questionnaire was optimal for clinical and research settings. Six tools were prospectively investigated: 1) the Disabilities Arm Shoulder and Hand (DASH), 2) Quick (Q)-DASH, 3) Q-DASH-10, 4) Upper Extremity Functional Scale (UEFS), 5) Upper Extremity Functional Index (UEFI) and 6) Upper Limb Functional Index (ULFI). Final comparisons between questionnaires were made using the Measurement of Outcome Measures (MOM). Two hundred and twenty-nine subjects completed the ULFI whilst two subgroups concurrently completed: a) the Q-DASH, Q-DASH-10 and UEFI and b) the DASH and UEFS. Psychometric properties analysed included reliability, validity, responsiveness, internal consistency, error scores, impairment distribution range and factor analysis. Practical characteristics included completion and scoring time, errors and missing responses. Each tool demonstrated the required psychometric properties and a single or two factor structure. Validity and responsiveness were similar and satisfactory as was reliability (ICC, 2:1 > 0.92) whilst subsequent error scores ranged from 5%-10%. Item redundancy was present in the DASH and UEFI. Missing responses ranged from 0% (ULFI) to 34% (DASH). Combined patient and therapist scoring time ranged from 45 seconds (UEFS) to 300 seconds (DASH). The MOM methodology demonstrated questionnaire efficacy for the ULFI at 96%, Q-DASH-10 at 90%, Q-DASH at 88%, UEFI at 84% with the DASH and UEFS at 68%. The ULFI was the preferred tool, the Quick- DASH-10 sacrificed sensitivity, construct diversity and error range for completion efficiency. The UEFI and DASH had item redundancy, the Quick-DASH poor practicality and the UEFS poor psychometrics.