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Measurement properties of the QuickDASH (Disabilities of the Arm, Shoulder and Hand) outcome measure and cross-cultural adaptations of the QuickDASH: a systematic review

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Abstract

Purpose

To identify and synthesize evidence for the measurement properties of the QuickDASH, a shortened version of the 30-item DASH (Disabilities of the Arm, Shoulder and Hand) instrument.

Methods

This systematic review used a best evidence synthesis approach to critically appraise the measurement properties [using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN)] of the QuickDASH and cross-cultural adaptations. A standard search strategy was conducted between 2005 (year of first publication of QuickDASH) and March 2011 in MEDLINE, EMBASE and CINAHL.

Results

The search identified 14 studies to include in the best evidence synthesis of the QuickDASH. A further 11 studies were identified on eight cross-cultural adaptation versions.

Conclusions

Many measurement properties of the QuickDASH have been evaluated in multiple studies and across most of the measurement properties. The best evidence synthesis of the QuickDASH English version suggests that this tool is performing well with strong positive evidence for reliability and validity (hypothesis testing), and moderate positive evidence for structural validity testing. Strong negative evidence was found for responsiveness due to lower correlations with global estimates of change. Information about the measurement properties of the cross-cultural adaptation versions is still lacking, or the available information is of poor overall methodological quality.

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Acknowledgments

Peter Smith is supported by a New Investigator Award from the Canadian Institutes of Health Research during completion of this work. He is currently the recipient of a Discovery Early Career Research Award from the Australian Research Council. Kenneth Tang is the recipient of a Canadian Institutes of Health Research Ph.D. Fellowship, Canadian Arthritis Network Graduate Award and Syme Fellowship from the Institute for Work & Health.

Author information

Authors and Affiliations

  1. Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada

    Carol A. Kennedy, Dorcas E. Beaton, Peter Smith, Dwayne Van Eerd, Kenneth Tang, Sheilah Hogg-Johnson & Rachel Couban

  2. Mobility Program Clinical Research Unit, St. Michael’s Hospital, 30 Bond St., 193 Yonge St., 6th Floor, Toronto, ON, M5B 1W8, Canada

    Carol A. Kennedy, Dorcas E. Beaton, Kenneth Tang, Taucha Inrig & Denise Linton

  3. The Alfred Centre, School of Public Heath and Preventive Medicine, Monash University, 6th Floor, 99 Commercial Road, Melbourne, VIC, 3004, Australia

    Peter Smith

  4. Department of Physical Therapy, University of Toronto, Toronto, ON, Canada

    Carol A. Kennedy

  5. Department of Health Policy, Management and Evaluation, Graduate Department of Rehabilitation Science and Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada

    Dorcas E. Beaton

  6. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Peter Smith & Sheilah Hogg-Johnson

  7. School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada

    Dwayne Van Eerd

  8. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Kenneth Tang

Authors
  1. Carol A. Kennedy
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  2. Dorcas E. Beaton
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  3. Peter Smith
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  4. Dwayne Van Eerd
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  5. Kenneth Tang
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  6. Taucha Inrig
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  7. Sheilah Hogg-Johnson
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  8. Denise Linton
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  9. Rachel Couban
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Corresponding author

Correspondence to Carol A. Kennedy.

Additional information

The DASH was jointly developed by the Institute for Work & Health (IWH) and the American Academy of Orthopedic Surgeons (AAOS). Copyright of the DASH/QuickDASH Outcome Measure was transferred in 2005 from joint copyright between IWH and AAOS to one of sole copyright to IWH. Two authors of this paper (DEB, SHJ) were part of the DASH development group.

Appendices

Appendix 1: Complete search strategy

MEDLINE (OVID)

  1. 1.

    Disabilities of the arm shoulder hand.mp.

  2. 2.

    DASH.mp.

  3. 3.

    Quickdash.mp.

  4. 4.

    (Dynamic allele specific hybridi#ation or hybridi#ation).mp.

  5. 5.

    (Dietary approaches to stop hypertension or hypertension).mp.

  6. 6.

    Diagnostic assessment for the severely handicapped.mp.

  7. 7.

    Dash II.mp.

  8. 8.

    Heterocyclic compounds.mp.

  9. 9.

    Dash protein.mp.

  10. 10.

    or/1-3

  11. 11.

    or/4-9

  12. 12.

    10 not 11

  13. 13.

    Exp Arm/or exp Upper Extremity/

  14. 14.

    Exp Shoulder/

  15. 15.

    Exp Hand/

  16. 16.

    Exp Orthopedics/

  17. 17.

    Exp Orthopedic Procedures/

  18. 18.

    Exp Neurosurgery/

  19. 19.

    Exp Neurosurgical Procedures/

  20. 20.

    Exp Microsurgery/

  21. 21.

    Exp “Prostheses and Implants”/

  22. 22.

    Exp Disability Evaluation/

  23. 23.

    Exp Mobility Limitation/

  24. 24.

    Exp “Range of Motion, Articular”/

  25. 25.

    Exp Fracture Healing/

  26. 26.

    Exp Fracture Fixation/

  27. 27.

    Exp Carpal Tunnel Syndrome/

  28. 28.

    Exp Hand Strength/

  29. 29.

    Exp Hand Injuries/

  30. 30.

    Exp Tendon Injuries/

  31. 31.

    Exp “Severity of Illness Index”/

  32. 32.

    Exp “Recovery of Function”/

  33. 33.

    Exp Physical Fitness/

  34. 34.

    Exp Body Composition/

  35. 35.

    Exp “Activities of Daily Living”/

  36. 36.

    Exp Pain Measurement/

  37. 37.

    Or/13-36

  38. 38.

    Exp Questionnaires/

  39. 39.

    Exp “Reproducibility of Results”/

  40. 40.

    Exp Research Design/

  41. 41.

    Exp Translations/

  42. 42.

    Exp Treatment Outcome/

  43. 43.

    Or/38-42

  44. 44.

    37 and 43 and 12

  45. 45.

    12 and 37

  46. 46.

    12 not 37

  47. 47.

    44 or 46

EMBASE (OVID)

  1. 1.

    Disabilities of the arm shoulder hand.mp.

  2. 2.

    DASH.mp.

  3. 3.

    Exp QuickDASH questionnaire/or exp quickdash scale/or exp QuickDASH/or quickdash.mp.

  4. 4.

    Or/1–3

  5. 5.

    Hybridisation.mp. or exp Hybridization/

  6. 6.

    Exp HYPERTENSION/

  7. 7.

    Dietary approaches to stop hypertension.mp.

  8. 8.

    Diagnostic assessment for the severely handicapped.mp.

  9. 9.

    Dash II.mp.

  10. 10.

    Exp Heterocyclic Compound/

  11. 11.

    Dash protein.mp.

  12. 12.

    Or/5-11

  13. 13.

    4 not 12

  14. 14.

    Upper extremity.mp. or exp Arm/

  15. 15.

    Exp SHOULDER/

  16. 16.

    Exp HAND/

  17. 17.

    Exp ORTHOPEDICS/

  18. 18.

    Exp Orthopedic Surgery/

  19. 19.

    Exp NEUROSURGERY/

  20. 20.

    Exp MICROSURGERY/

  21. 21.

    Exp PROSTHESIS/

  22. 22.

    Disability evaluation.mp.

  23. 23.

    Mobility limitation.mp.

  24. 24.

    Exp “Range of Motion”/

  25. 25.

    Exp Joint Mobility/

  26. 26.

    Exp Joint Function/

  27. 27.

    Exp Fracture Healing/

  28. 28.

    Exp Fracture Fixation/

  29. 29.

    Exp Carpal Tunnel Syndrome/

  30. 30.

    Exp Grip Strength/

  31. 31.

    Exp Hand Function/

  32. 32.

    Exp Hand Injury/

  33. 33.

    Exp Tendon Injury/

  34. 34.

    Exp Disease Severity/

  35. 35.

    Exp CONVALESCENCE/

  36. 36.

    Exp FITNESS/

  37. 37.

    Exp Body Composition/

  38. 38.

    Exp Daily Life Activity/

  39. 39.

    Exp Pain Assessment/

  40. 40.

    Or/14-39

  41. 41.

    Exp QUESTIONNAIRE/

  42. 42.

    Exp REPRODUCIBILITY/

  43. 43.

    Exp METHODOLOGY/

  44. 44.

    Translations.mp. or exp Publication/

  45. 45.

    Exp Treatment Outcome/

  46. 46.

    Or/41-45

  47. 47.

    46 and 40 and 13

  48. 48.

    40 and 13

  49. 49.

    13 not 48

  50. 50.

    49 or 47

CINAHL (EBSCO)

S49:

S48 or S46

S48:

S13 not S39

S47:

S39 and S13

S46:

S45 and S39 and S13

S45:

S44 or S43 or S42 or S41 or S40

S44:

(MH “Treatment Outcomes + ”)

S43:

(MH “Translations”)

S42:

(MH “Study Design”)

S41:

(MH “Reproducibility of Results”)

S40:

(MH “Questionnaires + ”)

S39:

S38 or S37 or S36 or S35 or S34 or S33 or S32 or S31 or S30 or S29 or S28 or S27 or S26 or S25 or S24 or S23 or S22 or S21 or S20 or S19 or S18 or S17 or S16 or S15 or S14

S38:

(MH “Pain Measurement”)

S37:

(MH “Activities of Daily Living + ”)

S36:

(MH “Body Composition + ”)

S35:

(MH “Physical Fitness”)

S34:

(MH “Functional Status”)

S33:

(MH “Recovery”)

S32:

(MH “Severity of Injury”)

S31:

(MH “Severity of Illness”)

S30:

(MH “Tendon Injuries + ”)

S29:

(MH “Hand Injuries + ”)

S28:

(MH “Grip Strength”)

S27:

(MH “Carpal Tunnel Syndrome”)

S26:

(MH “Fracture Fixation”)

S25:

(MH “Fracture Healing”)

S24:

(MH “Range of Motion”)

S23:

(MH “Physical Mobility”)

S22:

(MH “Disability Evaluation + ”)

S21:

(MH “Prostheses and Implants + ”)

S20:

(MH “Microsurgery + ”)

S19:

(MH “Neurosurgery + ”)

S18:

(MH “Orthopedics”) or (MH “Orthopedic Surgery”) or (MH “Orthopedic Care”)

S17:

(MH “Hand+ ”)

S16:

(MH “Shoulder”)

S15:

(MH “Arm”)

S14:

(MH “Upper Extremity+ ”)

S13:

S4 not S12

S12:

S11 or S10 or S9 or S8 or S7 or S6 or S5

S11:

“dash protein”

S10:

(MH “Heterocyclic Compounds+ ”)

S9:

“Dash II”

S8:

“Diagnostic assessment for the severely handicapped”

S7:

(MH “Hypertension+ ”)

S6:

“Dietary approaches to control hypertension”

S5:

Hybridi?ation

S4:

S3 or S2 or S1

S3:

Quickdash

S2:

DASH

S1:

“Disabilities of the arm shoulder hand”

New CINAHL (revised 2010 by tech support at EBSCO)

S49:

S48 or S46

S48:

S13 not S39

S47:

S39 and S13

S46:

S45 and S39 and S13

S45:

S44 or S43 or S42 or S41 or S40

S44:

(MH “Treatment Outcomes + ”)

S43:

(MH “Translations”)

S42:

(MH “Study Design”)

S41:

(MH “Reproducibility of Results”)

S40:

(MH “Questionnaires + ”)

S39:

S38 or S37 or S36 or S35 or S34 or S33 or S32 or S31 or S30 or S29 or S28 or S27 or S26 or S25 or S24 or S23 or S22 or S21 or S20 or S19 or S18 or S17 or S16 or S15 or S14

S38:

(MH “Pain Measurement”)

S37:

(MH “Activities of Daily Living + ”)

S36:

(MH “Body Composition + ”)

S35:

(MH “Physical Fitness”)

S34:

(MH “Functional Status”)

S33:

(MH “Recovery”)

S32:

(MH “Severity of Injury”)

S31:

(MH “Severity of Illness”)

S30:

(MH “Tendon Injuries + ”)

S29:

(MH “Hand Injuries + ”)

S28:

(MH “Grip Strength”)

S27:

(MH “Carpal Tunnel Syndrome”)

S26:

(MH “Fracture Fixation”)

S25:

(MH “Fracture Healing”)

S24:

(MH “Range of Motion”)

S23:

(MH “Physical Mobility”)

S22:

(MH “Disability Evaluation + ”)

S21:

(MH “Prostheses and Implants + ”)

S20:

(MH “Microsurgery + ”)

S19:

(MH “Neurosurgery + ”)

S18:

(MH “Orthopedics”) or (MH “Orthopedic Surgery”) or (MH “Orthopedic Care”)

S17:

(MH “Hand + ”)

S16:

(MH “Shoulder”)

S15:

(MH “Arm”)

S14:

(MH “Upper Extremity + ”)

S13:

S4 not S12

S12:

S11 or S10 or S9 or S8 or S7 or S6 or S5

S11:

“Dash protein”

S10:

(MH “Heterocyclic Compounds + ”)

S9:

“Dash II”

S8:

“Diagnostic assessment for the severely handicapped”

S7:

(MH “Hypertension + ”)

S6:

“Dietary approaches to control hypertension”

S5:

Hybridi?ation

S4:

S3 or S2 or S1

S3:

Quickdash

S2:

DASH

S1:

“Disabilities of the arm shoulder hand”

Appendix 2

See Table 6.

Table 6 Quality criteria for measurement properties (13) [based on Terwee (12)] and COSMIN taxonomy definitions in italics (7)
Full size table

Appendix 3

See Table 7.

Table 7 Reported measurement properties per instrument: internal consistency, test–retest reliability and measurement error
Full size table

Appendix 4

See Table 8.

Table 8 Reported measurement properties per instrument: structural validity
Full size table

Appendix 5

See Table 9.

Table 9 Reported measurement properties per instrument: hypothesis testing (validity). (The table is divided into three sections. The first describes the results of correlation with related constructs; the second, the results of low correlation with unrelated constructs; and the third, the results of known-groups construct validation)
Full size table

Appendix 6

See Table 10.

Table 10 Reported measurement properties per instrument: responsiveness
Full size table

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Kennedy, C.A., Beaton, D.E., Smith, P. et al. Measurement properties of the QuickDASH (Disabilities of the Arm, Shoulder and Hand) outcome measure and cross-cultural adaptations of the QuickDASH: a systematic review. Qual Life Res 22, 2509–2547 (2013). https://doi.org/10.1007/s11136-013-0362-4

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