Specificity of the minimal clinically important difference of the quick Disabilities of the Arm Shoulder and Hand (QDASH) for distal upper extremity conditions

Enrique V. Smith-Forbes, Dana M. Howell, Jason Willoughby, Donald G. Pitts, Tim L. Uhl

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Retrospective cohort design. The minimal clinically important difference (MCID) for the quick Disabilities of the Arm, Shoulder and Hand (QDASH) has been established using a pool of multiple conditions, and only exclusively for the shoulder. Understanding diagnoses-specific threshold change values can enhance the clinical decision-making process. Before and after QDASH scores for 406 participants with conditions of surgical distal radius fracture, non-surgical lateral epicondylitis, and surgical carpal tunnel release were obtained. The external anchor administered at each fourth visit was a 15-point global rating of change scale. The test-retest reliability of the QDASH was moderate for all diagnoses: intraclass correlation coefficient model 2, 1, for surgical distal radius = 0.71; non-surgical lateral epicondylitis = 0.69; and surgical carpal tunnel = 0.69. The minimum detectable change at the 90% confidence level was 25.28; 22.49; and 27.63 points respectively; and the MCID values were 25.8; 15.8 and 18.7, respectively. For these three distal upper extremity conditions, a QDASH MCID of 16–26 points could represent the estimate of change in score that is important to the patient and guide clinicians through the decision-making process.

Original languageEnglish
Pages (from-to)81-88
Number of pages8
JournalJournal of Hand Therapy
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2016

Bibliographical note

Publisher Copyright:
© 2016

Keywords

  • Disability evaluation
  • Musculoskeletal diseases
  • Outcome assessment
  • Psychometrics
  • Rehabilitation
  • Upper extremity

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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