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Concurrent Validation of the DASH and the QuickDASH in Comparison to Neck-Specific Scales in Patients With Neck Pain

Mehta, Saurabh, PT, MSc (Rehab)*; MacDermid, Joy C., PhD*†; Carlesso, Lisa C., PT, MSc, FCAMPT; McPhee, Colleen, PT, FCAMPT, MSc (Rehab)

doi: 10.1097/BRS.0b013e3181c85151
Health Services Research
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Study Design. Concurrent validity study.

Objective. To examine the validity of the Disabilities of Arm, Shoulder, and Hand (DASH) and the QuickDASH in patients with neck pain in comparison with the Neck Disability Index (NDI), the Cervical Spine Outcome Questionnaire (CSOQ), and the Visual Analogue Scale (VAS) for pain. To examine the agreement between the DASH and the QuickDASH and assess whether the QuickDASH can be used instead of full DASH in patients with neck pain.

Summary of Background Data. NDI is commonly used for measuring neck-related disability in patients with neck pain; but it does not offer to assess the potential for upper extremity disability.

Methods. Patients with neck pain (N = 66) were assessed on one occasion. They completed the NDI and the DASH, and 42 of them completed the CSOQ. The QuickDASH scores were extracted from the full DASH. Correlations were tested between both versions of the DASH, the NDI, the subscales of the CSOQ, and the VAS-pain. Correlations were considered high with r >0.75. Ranked item difficulty analysis was performed for both versions of the DASH and the NDI. The Bland and Altman technique was used to assess the nature and size of score differences between 2 versions of the DASH.

Results. Item ranks identified the DASH and the QuickDASH items to be as problematic to patients as NDI items. Both the versions of DASH showed high correlation (0.82-0.83) with the NDI and moderate correlation with the CSOQ and VAS-pain. The mean QuickDASH scores were higher (2.77 points) compared to the full DASH.

Conclusion. Though the QuickDASH reported higher disability compared to the full DASH in this patient group, high correlation between the QuickDASH and the NDI and agreement between both versions of the DASH provide preliminary evidence that the QuickDASH can be used to measure upper extremity disability in patients with neck pain.

The concurrent validity of the DASH and the QuickDASH was assessed and compared to the Neck Disability Index and the Cervical Spine Outcome Questionnaire in patients with neck pain. The study provides evidence to support the use of the QuickDASH to measure upper extremity disability in patients with neck pain.

From the *School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada; †Clinical Research Laboratory, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Ontario, Canada; ‡Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; and §St. Joseph's Healthcare, Centre for Acute Injury Rehabilitation, Hamilton, Ontario, Canada.

Acknowledgment date: July 23, 2009. First revision date: September 26, 2009. Acceptance date: September 28, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Supported by Quality of Life Training Program, Canadian Institutes of Health Research and Musculoskeletal Pain Grant, Canadian Institutes of Health Research (to S.M. and L.C.C.) and by a New Investigator Award, Canadian Institutes of Health Research (to J.C.M.).

Ethics approval for the study obtained from the McMaster University Faculty of Health Sciences Board.

Address correspondence and reprint requests to Saurabh Mehta, MSc, PhD student, School of Rehabilitation Science, McMaster University, 1400 Main Street West-IAHS 402, Hamilton, Ontario L8S 1C7, Canada; E-mail: mehtas8@mcmaster.ca

© 2010 Lippincott Williams & Wilkins, Inc.