Rysstad Tarjei, Røe Yngve, Haldorsen Benjamin, Svege Ida, Strand Liv Inger
Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Postboks 4, St Olavs Plass, Oslo, Norway.
Department of Physiotherapy, Martina Hansens Hospital, Bærum, Norway.
BMC Musculoskelet Disord. 2017 Jun 8;18(1):248. doi: 10.1186/s12891-017-1616-z.
BACKGROUND: The Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) is a valid and reliable patient-reported outcome measure (PROM). It was designed to measure physical disability and symptoms in patients with musculoskeletal disorders of the upper extremity, and is one of the most commonly used PROMs for patients with shoulder pain. The aim of this study was to examine responsiveness, the smallest detectable change (SDC) and the minimal important change (MIC) of the DASH, in line with international (COSMIN) recommendations. METHODS: The study sample consisted of 50 patients with subacromial pain syndrome, undergoing physical therapy for 3-4 months. Responsiveness to change was examined by calculating area under the receiver operating characteristic curves (AUC) and testing a priori-formulated hypothesis regarding correlations with changes in other instruments that measuring the same construct. The SDC was calculated using a test re-test protocol, and the MIC was calculated by the anchor-based MIC distribution. MIC values for patients with low and high baseline scores were also calculated. RESULTS: DASH appeared to be responsive, as it was able to distinguish patients who reported to be improved from those unchanged (AUC 0.77). All of the hypotheses were accepted. The SDC was 11.8, and the MIC was 4.4. CONCLUSION: This study shows that the Norwegian version of the DASH has good responsiveness to change and may thus be recommended to measure outcome in patients with shoulder pain in Norway.
背景:上肢功能障碍、肩部与手部问卷(DASH)是一种有效且可靠的患者报告结局指标(PROM)。它旨在测量上肢肌肉骨骼疾病患者的身体残疾和症状,是肩部疼痛患者最常用的PROM之一。本研究的目的是根据国际(COSMIN)建议,检验DASH的反应度、最小可检测变化(SDC)和最小重要变化(MIC)。 方法:研究样本包括50例患有肩峰下疼痛综合征且接受3 - 4个月物理治疗的患者。通过计算受试者工作特征曲线下面积(AUC)并检验关于与测量相同结构的其他工具变化的相关性的先验假设,来检验对变化的反应度。使用重测协议计算SDC,并通过基于锚定的MIC分布计算MIC。还计算了基线分数低和高的患者的MIC值。 结果:DASH似乎具有反应度,因为它能够区分报告病情改善的患者和未改善的患者(AUC为0.77)。所有假设均被接受。SDC为11.8,MIC为4.4。 结论:本研究表明,挪威版DASH对变化具有良好的反应度,因此可能推荐用于测量挪威肩部疼痛患者的结局。
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