The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: Reliability and validity of the Swedish version evaluated in 176 patients

TLDR

The DASH questionnaire is a self‑administered, 30‑item instrument designed to assess upper‑extremity disability and symptoms. We cross‑culturally adapted the DASH to Swedish through double forward‑backward translations, expert and lay review, and field‑testing, then evaluated its reliability and validity in 176 patients who completed the DASH and SF‑12 before surgery or therapy. The Swedish DASH showed high internal consistency (α = 0.96), excellent test‑retest reliability (ICC = 0.92), and construct validity evidenced by strong correlations with SF‑12 physical scores, self‑rated global health, and discrimination among conditions, confirming it as a reliable, valid patient‑centered outcome measure.

Abstract

AbstractThe disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered regionspecific outcome instrument developed to measure upperextremity disability and symptoms. The DASH consists mainly of a 30-item disability/symptom scale. We performed cross-cultural adaptation of the DASH to Swedish, using a process that included double forward and backward translations, expert and lay review, as well as field-testing to achieve linguistic and conceptual equivalence. The Swedish version's reliability and validity were then evaluated in 176 patients with upper-extremity conditions. The patients completed the DASH and SF-12 generic health questionnaire before elective surgery or physical therapy. Internal consistency of the DASH was high (Cronbach alpha 0.96). Test-retest reliability, evaluated in a subgroup of 67 patients who completed the DASH on two occasions, with a median interval of 7 days, was excellent (intraclass correlation coefficient 0.92). Construct validity was shown by a positive correlation of DASH scores with the SF-12 scores (worse upper-extremity disability correlating with worse general health), stronger correlation with the SF-12 physical than with the mental health component, correlation of worse DASH scores with worse self-rated global health, and ability to discriminate among conditions known to differ in severity. The Swedish version of the DASH is a reliable and valid instrument that can provide a standardized measure of patient-centered outcomes in upper-extremity musculoskeletal conditions.