Raven Eric E J, Haverkamp Daniël, Sierevelt Inger N, van Montfoort Douwe O, Pöll Ruud G, Blankevoort Leendert, Tak Paul P
Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands.
J Rheumatol. 2008 Dec;35(12):2334-8. doi: 10.3899/jrheum.080067. Epub 2008 Nov 1.
The Disability of Arm, Shoulder and Hand (DASH) questionnaire is a tool for measuring physical function and symptoms of the upper extremity. Although widely used, it is not validated for rheumatoid arthritis (RA). In this study the DASH was validated for this patient group.
In total, 102 patients participated in this study. For the validation, the questionnaires of the DASH, the Health Assessment Questionnaire (HAQ), the Medical Outcomes Study Short Form-36 (SF-36), and the Arthritis Impact Measurement Scale (AIMS2) were used. Patients were examined clinically before completing the questionnaires. Pain was scored by each patient using a visual analog scale (VAS). The Disease Activity Score (DAS28) was obtained and grip strength was measured. Reliability was tested by a second DASH questionnaire after 2 days. Validity was tested using a Pearson correlation analysis for the relevant domains of the questionnaires and for the clinical aspects.
The reliability of the DASH was excellent (intraclass correlation coefficient 0.97). Internal consistency was strong (Cronbach's alpha 0.97). Validity was proven with excellent results for Pearson correlation with the relevant domains of the questionnaires: HAQ, r = 0.88; SF-36, r = 0.70; and AIMS2, r = 0.85. The clinical scores had a relatively low correlation with the DASH (DAS28, r = 0.42; and grip strength, r = 0.41-0.48), except for the VAS (r = 0.60-0.65).
The DASH is a reliable and valid questionnaire in patients with RA. It can be used as a measurement tool of physical disability of the upper extremity.
上肢功能障碍（DASH）问卷是一种用于测量上肢身体功能和症状的工具。尽管被广泛使用，但它尚未在类风湿关节炎（RA）患者中得到验证。在本研究中，DASH问卷在该患者群体中得到了验证。
共有102名患者参与了本研究。为进行验证，使用了DASH问卷、健康评估问卷（HAQ）、医学结局研究简明健康调查问卷（SF-36）和关节炎影响测量量表（AIMS2）。患者在完成问卷之前接受临床检查。每位患者使用视觉模拟量表（VAS）对疼痛进行评分。获取疾病活动评分（DAS28）并测量握力。2天后通过第二份DASH问卷测试可靠性。使用Pearson相关分析对问卷的相关领域和临床方面进行效度测试。
DASH问卷的可靠性极佳（组内相关系数为0.97）。内部一致性较强（Cronbach's alpha为0.97）。通过与问卷相关领域的Pearson相关性分析证明了效度，结果优异：与HAQ的相关性，r = 0.88；与SF-36的相关性，r = 0.70；与AIMS2的相关性，r = 0.85。除VAS外（r = 0.60 - 0.65），临床评分与DASH的相关性相对较低（DAS28，r = 0.42；握力，r = 0.41 - 0.48）。
DASH问卷在RA患者中是一种可靠且有效的问卷。它可作为上肢身体残疾的测量工具。
