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Osteoarthritis: (Vermeulen et al, 2009; n = 19, Primary Thumb Carpometacarpal Osteoarthritis; evaluated at 0, 3, 6 and 12 months, Osteoarthritis)

Analysis of the Change in DASH Score From Preoperative Clinical Evaluations

*Paired differences of the DASH scores. DASH 0 is mean DASH score preoperative, DASH 3 is mean DASH score at 3 months, DASH 6 is mean DASH score at 6 months, and DASH 12 is mean DASH score at 12 months.

Osteoarthritis: (MacDermid et al., 2007; n = 122; mean age = 65.4 (8.1) years; time since surgery = 54.2 (23.1) months)

Arthroplasty of the carpometacarpal joint for osteoarthritis

PRWHE: Patient-Rated Wrist Hand Evaluation; DASH: Disabilities of Arm, Shoulder, and Hand Questionnaire; SF-36: Short Form 36

Rheumatoid Arthritis: (Chiari-Grisar et al, 2006; n = 37; Function following finger joint arthroplasty in patients with rheumatoid arthritis; study performed in Austria; grip strength scores measured with a Martin vigorimeter, Rheumatoid Arthritis)

DASH: Disabilities of Arm, Shoulder, and Hand Questionnaire; HAQ: Health Assessment Questionnaire

Rheumatoid Arthritis: (Raven et al., 2008)

• ICC = 0.97

Swedish Patients with Rheumatoid Arthritis: (Bilberg, Bremell, & Mannerkorpi, 2012; n = 67) 

• ICC = 0.99 (95% CI, 0.98-0.99)

Rheumatoid Arthritis: (Raven et al., 2008)

• Cronbach's alpha = 0.97

Osteoarthritis: (MacDermid et al., 2007; n = 122; function following arthroplasty of the carpometacarpal joint of the hand for osteoarthritis; Osteoarthritis)

Correlations of the SF-36 component summary scores with PRWHE and DASH Scores

All correlations significant at the 0.01 level (2-tailed); SF-36: Short Form 36; PRWHE: Patient-Rated Wrist Hand Evaluation

Correlation between self-report function scores and measured impairments*

*Impairments measured using the NK Hand Assessment System; **Correlation significant at 0.01 (2-tailed). *Correlation significant at 0.05 (2-tailed); PRWHE: Patient-Rated Wrist Hand Evaluation; DASH: Disabilities of Arm, Shoulder, Hand

Rheumatoid Arthritis: (Chiari-Grisar et al., 2006; n = 37; Function following finger joint arthroplasty in patients with rheumatoid arthritis; study performed in Austria, Rheumatoid Arthtitis)

SF-36: Short Form 36; DASH: Disabilities of Arm, Shoulder, Hand

Rheumatoid Arthritis: (Raven et al., 2008)

• Correlation of DASH and other outcome measures: (Pearson correlation)
  • Health Assessment Questionnaire ¨C r = 0.88
  • SF-36 ¨C r = 0.70
  • Arthritis Impact Measurement Scale ¨C r = 0.85
  • Disease Activity Score ¨C r = 0.42
  • Grip Strength ¨C r = 0.41-0.48
  • Visual Analog Scale ¨C r = 0.60-0.65

Swedish Patients with Rheumatoid Arthritis: (Bilberg, Bremell, & Mannerkorpi, 2012; n = 67)

• Correlation of DASH and other outcome measures: (Spearman correlation)
  • Health Assessment Questionnaire ¨C r = 0.80
  • Active shoulder-arm motion ¨C r = -0.38 to -0.50
  • Handgrip force ¨C r = -0.46 to -0.59
  • Activity-Induced pain ¨C r = 0.66
  • Disease Activity Score in 28 joints ¨C r = 0.63

Rheumatoid Arthritis: (Raven et al., 2008)

• Floor effect: none
• Ceiling effect: none

Proximal Humeral Fractures: (Slobogean et al., 2010; n = 61, mean age = 69, Proximal Humeral Fractures)

• Calculated using SEM = Standard Deviation of first outcome * square root (1-ICC)
• SEM = 21.7 * square root (1 - 0.928) = 5.82

Proximal Humeral Fractures: (Slobogean et al., 2010; n = 61, mean age = 69, Proximal Humeral Fractures)

• Calculated from MDC = 1.96 * SEM * (square root of 2)
• MDC = 1.96 * 5.82 * (square root of 2) = 16.1

Total Elbow Arthroplasty: (Angst et al., 2012; n = 65; 61.9 (13.0), Total Elbow Arthroplasty)

• Standard Response Mean = 0.55, Effect Size = 0.20)

Pre-Operative and Post-Operative Change in UE Function: (Gummesson, Atroshi, & Ekdah, 2003; n = 109; patients had surgery for a variety of upper extermity conditions; assessed prior to surgery then again 6 to 21 months later; Swiss sample)

• Patients (n = 53) reporting "much better" or "much worse"
  • Mean Change = 19 (15 to 23) points
• Patients (n = 21) reporting "somewhat better" or "somewhat worse"
  • Mean Change = 10 (7 to 14) points
• Patients (n = 9) reporting "no change"
  • Mean change = -3 (-3 to 3.0) points

Elbow Disorders: (Angst et al., 2005; n = 79; mean age = 64.1 (13.3) years; time since surgery = 11.2 (3.0) years; Function following total elbow arthroplasty; Swiss sample)

SF-36: Short Form 36; DASH: Disabilities of the Arm, Shoulder, and Hand Questionnaire

Wrist Disorders: (Imaeda et al., 2010; n = 117; adapted by the Japanese Society for Surgery of the Hand, Japanese sample, Wrist Disorders)

Score for PRWE, DASH-JSSH, and VAS:

PRWE: Patient-Related Wrist Evaluation; DASH-JSSH: Disability/Symptom scale of the Japanese version of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnatire; VAS: Visual Analogue Scale for Pain (0-10 Scale); Maximum Health Status Scores (Ceiling)

Proximal Humeral Fractures: (Slobogean et al., 2010; n = 61, mean age = 69)

• Excellent test-retest reliability (ICC 2,1 = 0.928)

Total Elbow Arthroplasty: (Angst et al., 2012; n = 65; 61.9 (13.0))

• Excellent test-retest reliability (ICC = 0.96)

Proximal Humeral Fractures: (Slobogean et al., 2010; n = 61, mean age = 69, Proximal Humeral Fractures)

• See Test-retest reliability in Proximal Humeral Fractures for format

Proximal Humeral Fractures: (Slobogean et al., 2010; n = 61, mean age = 69, Proximal Humeral Fractures)

Spearman Correlations between Study Instruments

All correlations are significant to P < 0.01, except Self Function, HUI3 where P < 0.02.

Adhesive Capsulitis: (Staples, Forbes, Green, & Buchbinder, 2010)

• SPADI ¨C r = 0.55
• Croft Index ¨C r = 0.65
• Visual Analog Scale ¨C r = 0.31
• Health Assessment Questionnaire ¨C r = 0.54

Shoulder Arthroplasty (Switzerland, German-language): (Angst et al., 2004; n = 43)

• SF-36 (PCS) ¨C r = 0.67
• SF-36 (MCS) ¨C r = 0.06
• SPADI ¨C r = 0.93
• pASES ¨C r = 0.79
• cASES ¨C r = 0.59
• Constant Shoulder ¨C r = 0.82

Elbow Disorders: (Angst et al., 2005)

DASH Floor and Ceiling Effects:

Proximal Humeral Fractures: (Slobogean et al., 2010; n = 61, mean age = 69)

• No Floor effect established
• Moderate: 7% ceiling effect

Total Elbow Arthroplasty: (Angst et al., 2012; n = 65; 61.9 (13.0))

• Effect Size = 0.56, Sensitivity = 0.59, Specificity = 0.71

Wrist Disorders: (Imaeda et al, 2010; n = 117; Japanese Version, adapted by the Japanese Society for Surgery of the Hand)

Standardized Response Means and Effect Size of PRWE and DASH

SRM, Standardized Response Means; PRWE, Patient-Related Wrist Evaluation; VAS, Visual Analogue Scale; ***Significant difference between the preoperative and postoperative median values (p < 0.001)

Adults with musculoskeletal upper extremity problems: (Schmitt & Di Fabio, 2004)

• SEM = 5.22

Adults with musculoskeletal upper extremity problems: (Beaton et al., 2001)

• SEM = 4.6

Proximal Humeral Fractures: (Slobogean et al., 2010; n = 61, mean age = 69, Proximal Humeral Fractures)

• Calculated using SEM = Standard Deviation of first outcome * square root (1-ICC)
• SEM = 21.7 * square root (1 - 0.928) = 5.82

Adults with musculoskeletal upper extremity problems: (Schmitt & Di Fabio, 2004)

• MDC90 = 12.2

Adults with musculoskeletal upper extremity problems: (Beaton et al., 2001)

• MDC90 = 10.7
• MDC95 = 12.75

Adults with upper extremity musculoskeletal complaints undergoing surgery: (Angst, Schwyzer, Aeschlimann, Simmen, Goldhahn, 2011)

• MCID = 10.2

Adults with musculoskeletal upper extremity problems: (Schmitt & Di Fabio, 2004)

• MCID = 10.2

Adults with musculoskeletal upper extremity problems: (Schmitt & Di Fabio, 2004)

• ICC = 0.91

Adults with musculoskeletal upper extremity problems: (Beaton et al., 2001)

• ICC = 0.96 (95% CI, 0.93-0.98)

Adults with upper extremity musculoskeletal complaints undergoing surgery: (Gummesson, Atroshi, & Ekdahl, 2003)

• Cronbach's alpha = 0.92-0.97

Convergent Validity:

Adults with musculoskeletal upper extremity problems: (Schmitt & Di Fabio, 2004)

• Global Disability Rating ¨C Spearman r = 0.67-0.71

Adults with musculoskeletal upper extremity problems: (Beaton et al., 2001)

• SPADI pain ¨C Pearson r = 0.79, Spearman r = 0.76
• SPADI function ¨C Pearson r = 0.85, Spearman r = 0.83

Discriminant Validity:

Adults with musculoskeletal upper extremity problems: (Beaton et al., 2001)

• Participants who were working with their upper limb condition and were able to continue to work had a significantly lower disability than those unable to work (26.8 vs. 50.7, t = -7.51, p < 0.0001).
• Similarly, the DASH was able to discriminate between those who could do everything they wanted to vs. those who could not (23.6 vs. 47.1, t = -5.81, p < 0.0001).

Adults with musculoskeletal upper extremity problems: (Beaton et al., 2001)

• Floor effect: none
• Ceiling effect: only 1 of 200 in the sample scored 0 points

Adults with Multiple Sclerosis: (Cano, Barrett, Zajicek, & Hobart, 2011)  

• Cronbach's alpha = 0.98

Intercollegiate Athletes: (Hsu et al., 2010; n = 321; mean age 19.4 (17.6-22.6) years; Pre-competition physical)

• 3.61 (Calculated from MDC = 1.96 x SEM x square root of 2; 10 = 1.96 x SEM x square root of 2)

Intercollegiate Athletes: (Hsu et al., 2010; n = 321; mean age 19.4 (17.6-22.6) years; Pre-competition physical)

• MDC = 10

Intercollegiate Athletes: (Hsu et al., 2010; n = 321; mean age 19.4 (17.6-22.6) years; Pre-competition physical)

Overhead Athletes: (Alberta et al., 2010; n = 252 mean age = 23.7)

• Adequate test-retest reliability (ICC = 0.536)

General Population: (Hunsaker, Cioffi, Amadio, Wright, & Caughlin, 2002)

• Cronbach's alpha = 0.94-0.98

Intercollegiate Athletes: (Hsu et al., 2010, Intercollegiate Athletes)

Neck Pain: (Mehta et al., 2010; n = 66, mean age= 40.6 (14.2))

• Both versions of the DASH showed high correlation (0.82-0.84) with the NDI and moderate correlation with the CSOQ and VAS.

Correlation Between Self-Report Measures

*Correlation is significant at the 0.01 level (2-tailed); CSOQ= Cervical spine outcome questionnaire; VAS= Visual Analog Scale

Neck Pain: (Huisstede et al., 2009; n = 679; 41.0 (23.0))

Neck Pain: (Huisstede et al., 2009; n = 679; 41.0 (23.0))

• DASH was considered acceptable for each (sub)group
• The responsiveness ratio was higher in the S-A-H¨Conly group (1.92) than in the N¨Conly group (1.38)