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The validity, reliability, responsiveness, and bias of the Manchester-Modified Disability of the Arm, Shoulder, and Hand score in hand injuries.

ABSTRACT: The Manchester-Modified Disability of Arm, Shoulder and Hand questionnaire (M(2) DASH) was developed by the authors as a modification to the original DASH questionnaire. In this study, we assessed the validity, reliability, responsiveness, and bias of the M(2) DASH questionnaire for hand injuries using completed M(2) DASH, Patient Evaluation Measure, and Michigan Hand Outcome questionnaires from 40 patients. The M(2) DASH scores showed significant positive correlations with the Patient Evaluation Measure and Michigan Hand Outcome scores suggesting validity. There was also no evidence of a statistical difference in the M(2) DASH scores when the condition had stabilized suggesting good test-retest reproducibility and reliability. The effect size and the standardized response mean for the M(2) DASH score were greater than those for the Patient Evaluation Measure and Michigan Hand Outcome scores establishing that the M(2) DASH is highly responsive. There was no gender, hand dominance, or dominant side injured bias for the M(2) DASH score. There was, however, a relatively weak association between age and the M(2) DASH score at presentation. We conclude that the M(2) DASH questionnaire is a robust region-specific outcome measure. It is a valid and responsive questionnaire with test-retest reliability proven for hand injuries in this study. Gender, handedness, and side injured did not cause bias in the responses.

SUBMITTER: Khan WS

PROVIDER: S-EPMC2787220 | biostudies-other | 2009 Dec

REPOSITORIES: biostudies-other

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Project description:STUDY DESIGN:Cross-cultural adaptation and psychometric evaluation. OBJECTIVE:The aim of this study was to translate the Neck Disability Index (NDI) into the simplified-Chinese language and to evaluate the reliability, validity, and responsiveness of the new questionnaire. SUMMARY OF BACKGROUND DATA:Neck pain is a major health problem resulting in major disability. NDI is the most frequently used scale for self-rating of disability due to neck pain. At present, there is no simplified-Chinese version of the NDI. The aims of this study were to culturally adapt and translate the NDI into the simplified-Chinese language (NDI-SC) and to evaluate its psychometric properties in patients with neck pain. METHODS:The NDI was translated into simplified-Chinese version based on established guidelines. A total of 70 patients participated in this study. Patients were asked to complete a set of questionnaires comprising of their demographic information, the NDI-SC, and a visual analog scale (VAS) of pain. Fifty-six patients returned after 1 to 2 weeks to complete the same set of questionnaires and the global rating of change (GROC) scale. Then, the NDI-SC was evaluated for content validity, construct validity, internal consistency, test-retest reliability, and responsiveness. RESULTS:The NDI-SC demonstrated excellent internal consistency (Cronbach ??=?0.92) and good test-retest reliability (ICC2,1?=?0.85). Content validity was confirmed as no floor or ceiling effects were detected for the NDI-SC total score. Construct validity was established with factor analysis revealing two-factor subscales explaining 66% of the variance. The NDI-SC showed a strong correlation with VAS (Rp?=?0.61, P?<?0.001) and a moderate correlation with GROC (Rs?=?0.46, P?<?0.001). The correlation between NDI-SC change scores and VAS change scores was also moderate (Rp?=?0.59, P?<?0.001). CONCLUSION:The results showed that the NDI-SC is a reliable, valid, and responsive instrument to measure functional limitations in patients with neck pain. LEVEL OF EVIDENCE:3.

Project description:BackgroundPatient-reported outcome measures (PROMs) are important tools in both clinical practice and research. However, no upper extremity PROM to assess physical disability is available in Nepali. The most commonly used and recommended questionnaire for the shoulder is the Disability of Arm, Shoulder and Hand (DASH). Therefore, the aim of the study was to translate and cross-culturally adapt the DASH into Nepali and determine its measurement properties.MethodsThe translation and cultural adaptation process followed international standard procedures. The translated Nepali version of the questionnaire (DASH-NP) was completed by 156 patients with shoulder pain from three Nepali hospitals at an initial assessment and by 121 at follow-up. A Nepali version of Global Rating of Change (GROC-NP) was completed at follow-up to dichotomise improved and stable participants. Measurement properties testing included: internal consistency (Cronbach's alpha), test-retest reliability (Intraclass Correlation Coefficient, ICC), Minimal Detectable Change (MDC), construct validity - factor analysis, hypothesis testing with the Shoulder Pain and Disability Index (SPADI) (Pearson Correlation = r) and responsiveness - Area Under the Curve with minimal important change.ResultsSignificant adaptations such as changing measurement units, activities and terminology were incorporated to improve cultural relevance. Internal consistency (α = 0.92) and test-retest reliability (ICC = 0.97, 95% CI: 0.94-0.98, p < 0.001) were excellent. The MDC was 11 out of 100 points. There were moderate-high positive correlations with the SPADI pain and disability items (rs = 0.63 and 0.81, P < 0.001). Four factor solution was retrieved for the DASH-NP. The Area Under the Curve was 0.69 (95% CI: 0.57 - 0.81, p < 0.001) with minimal important change of 11.2/100 points.ConclusionsThe Nepali translation of the DASH is comprehensible, easy to administer via self-report or interview. It is found to be a reliable, valid, and responsive measure in patients with shoulder pain in Nepal. The DASH-NP can be used to assess shoulder pain related disability in Nepal for clinical practice or research.

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The validity, reliability, responsiveness, and bias of the Manchester-Modified Disability of the Arm, Shoulder, and Hand score in hand injuries.

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