BACKGROUND The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and its abbreviated version, QuickDASH, are commonly used patient-reported outcome measures (PROMs) for the assessment of an upper-extremity disability. Theoretically, they can be used to compare the treatment outcomes of different upper-extremity conditions. Despite increasingly widespread use for some shoulder conditions, these questionnaires have not been rigorously validated for use to assess the outcomes of patients undergoing anatomic total shoulder arthroplasty (aTSA). The objective of this study was to validate the DASH and QuickDASH scores for a longitudinal outcome assessment of patients undergoing aTSA to treat advanced glenohumeral osteoarthritis (GHOA). METHODS In this study, 450 patients with a median age of 70.3 years (interquartile range [IQR] width, 11.7 years) were included; 52.4% of the patients were female. The DASH and QuickDASH questionnaires, the American Shoulder and Elbow Surgeons (ASES) score, the Simple Shoulder Test (SST), and the EuroQol-5 Dimensions (EQ-5D) questionnaire were completed preoperatively and at follow-ups of 3 months, 6 to 12 months, and a minimum of 2 years by patients undergoing aTSA. The criterion validity, construct validity, reliability, and responsiveness of the DASH and QuickDASH were assessed. RESULTS The DASH and QuickDASH scores demonstrated moderate to very strong correlations with the ASES scores (ρ = -0.83 to -0.62), SST scores (ρ = -0.73 to -0.55), and EQ-5D scores (ρ = -0.72 to -0.57); minimal floor or ceiling effects; internal consistency (Cronbach alpha > 0.80); and large Cohen d and standardized response means (<1.6) at all time points. Very strong positive correlations were observed between the DASH and QuickDASH scores at all time points (ρ = 0.96 to 0.97). CONCLUSIONS The DASH and QuickDASH scores, which are region-specific rather than shoulder-specific, are valid, reliable, and responsive PROMs for the evaluation of patients with advanced GHOA treated with aTSA. Therefore, the DASH and QuickDASH scores can be used to compare the outcomes of aTSA for the treatment of advanced GHOA with the outcomes of treatment of other upper-extremity disorders, potentially facilitating comparative cost-effectiveness and value analysis studies. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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验证 DASH 和 QuickDASH 用于解剖性全肩关节置换术治疗晚期盂肱骨关节炎的结果评估。


背景 手臂、肩部和手部残疾 （DASH） 问卷及其简化版本 QuickDASH 是评估上肢残疾的常用患者报告结果测量 （PROM）。理论上，它们可用于比较不同上肢疾病的治疗结果。尽管这些问卷在一些肩部疾病中的应用越来越广泛，但尚未得到严格验证，无法用于评估接受解剖型全肩关节置换术 （aTSA） 的患者的结局。本研究的目的是验证 DASH 和 QuickDASH 评分，用于对接受 aTSA 治疗晚期盂肱骨关节炎 （GHOA） 的患者进行纵向结果评估。方法 在这项研究中，纳入了 450 例中位年龄为 70.3 岁 （四分位距 [IQR] 宽度，11.7 岁） 的患者;52.4% 的患者为女性。DASH 和 QuickDASH 问卷、美国肩肘外科医生 （ASES） 评分、简单肩部试验 （SST） 和 EuroQol-5 维度 （EQ-5D） 问卷在术前和接受 aTSA 的患者在 3 个月、 6 至 12 个月和至少 2 年的随访中完成。评估了 DASH 和 QuickDASH 的标准效度、结构效度、可靠性和响应性。结果 DASH 和 QuickDASH 评分与 ASES 评分 （ρ = -0.83 至 -0.62）、SST 评分 （ρ = -0.73 至 -0.55） 和 EQ-5D 评分 （ρ = -0.72 至 -0.57） 表现出中度至极强相关性;最小的地板或天花板影响;内部稠度 （Cronbach alpha x3E 0.80）;以及所有时间点的大 Cohen d 和标准化反应均值 （<1.6）。 在所有时间点 （ρ = 0.96 至 0.97） ，在 DASH 和 QuickDASH 评分之间观察到非常强的正相关。结论 DASH 和 QuickDASH 评分是区域特异性而不是肩部特异性的，是有效、可靠且反应灵敏的 PROM，用于评估接受 aTSA 治疗的晚期 GHOA 患者。因此，DASH 和 QuickDASH 评分可用于比较 aTSA 治疗晚期 GHOA 的结果与其他上肢疾病的治疗结果，从而可能有助于比较成本效益和价值分析研究。证据级别 预后 III 级。有关证据级别的完整描述，请参阅作者说明。