Journal article
A modified QuickDASH-9 provides a valid outcome instrument for upper limb function
BMC Musculoskeletal Disorders, Vol.10, 161
2009
Abstract
Background:The 30-item Disabilities Arm Shoulder and Hand (DASH) questionnaire was introduced to facilitate assessment of upper limb functional limitations. To improve practicality and eliminate item redundancy a modified instrument was needed. The 11-item QuickDASH was developed to fulfil these requirements and translated into several languages. However, prospective investigations of psychometric and practical characteristics are limited. No published study investigated readability or used concurrent validation with a standardized upper limb criterion measure. The validity of the QuickDASH has been questioned as the results for factor structure are conflicting, and the English-language version has not yet had factor structure reported. A shortened 9-item version, the QuickDASH-9, that addresses these issues is proposed. Methods:This two-stage observational study assessed the psychometric and practical characteristics of the QuickDASH and the extracted QuickDASH-9. The Upper Limb Functional Index (ULFI) was the criterion standard in both stages. Stage 1, calibration, reanalyzed extracted QuickDASH and QuickDASH-9 responses from a previous prospective study, by the authors, of the 30-item DASH (n=137). Stage 2, prospective validation, investigated the QuickDASH through repeated measures in consecutive upper limb musculoskeletal participants' consulting for physical therapy in Australia (n=67). The QuickDASH and extracted QuickDASH-9 data from both stages was analyzed and compared for psychometric properties, practical characteristics and factor structure. ResultsThe proposed QuickDASH-9 had a unidimensional structure, high reliability (ICC 2:1, r=0.92), internal consistency (alpha=0.93) and responsiveness (ES=1.05). It correlated highly with both the DASH (r=0.97), QuickDASH (r=0.99) and ULFI criterion (r=0.85). QuickDASH-9 missing responses reduced to 3.5% from 26% in the QuickDASH. Completion and scoring time was 134+/-56 seconds and required a computational aid. The QuickDASH demonstrated a bidimensional structure making it invalid. The QuickDASH-9 summary performance was measured on the 'Measurement of Outcome Measures' at 88% and on the 'Bot' clinimetric scale at 75%. Conclusions: The proposed QuickDASH-9 had a unidimensional structure and similar psychometric precision to the full-length DASH with improved practicality and completion time. The QuickDASH was invalid as its bidimensional structure made a single summated score inappropriate. The QuickDASH-9 offers a future direction for ongoing use of the QuickDASH concept.
Details
- Title
- A modified QuickDASH-9 provides a valid outcome instrument for upper limb function
- Authors
- Charles P Gabel (Author) - University of the Sunshine Coast - Faculty of Science, Health and EducationM Yelland (Author) - Griffith UniversityM Melloh (Author) - University of Otago, New ZealandBrendan J Burkett (Author) - University of the Sunshine Coast - Faculty of Science, Health and Education
- Publication details
- BMC Musculoskeletal Disorders, Vol.10, 161; 11
- Publisher
- BioMed Central Ltd.
- Date published
- 2009
- DOI
- 10.1186/1471-2474-10-161
- ISSN
- 1471-2474
- Copyright note
- Copyright © 2009 Gabel et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This published version is reproduced in accordance with this policy.
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Health and Sport Sciences - Legacy; School of Health - Sports & Exercise Science
- Language
- English
- Record Identifier
- 99449458602621
- Output Type
- Journal article
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