PMID- 33484830
OWN - NLM
STAT- MEDLINE
DCOM- 20210823
LR  - 20220902
IS  - 1532-6500 (Electronic)
IS  - 1058-2746 (Print)
IS  - 1058-2746 (Linking)
VI  - 30
IP  - 9
DP  - 2021 Sep
TI  - The critical difference in the DASH (Disabilities of the Arm, Shoulder, and Hand) 
      outcome measure after essential upper extremity tumor surgery.
PG  - e602-e609
LID - S1058-2746(21)00018-5 [pii]
LID - 10.1016/j.jse.2020.11.027 [doi]
AB  - BACKGROUND: The DASH (Disabilities of the Arm, Shoulder, and Hand) is a scored 
      questionnaire that is widely used to evaluate the health-related quality of life 
      of patients with upper limb musculoskeletal disorders. However, numerical changes 
      in the measure scores lack clinical significance without meaningful threshold 
      change values of outcome measures that are diagnostically specific. The minimal 
      clinically important difference (MCID) is useful for the interpretation of scores 
      by defining the smallest change that a patient would perceive. However, the MCIDs 
      of the scores in orthopedic oncology patients has not been reported. We aimed to 
      determine the MCIDs of the measure in orthopedic oncology patients. METHODS: Data 
      from our health-related quality of life database from 1999 to 2005 were 
      retrospectively reviewed after institutional review board approval. Seventy-eight 
      patients who underwent surgery and completed 2 surveys during postoperative 
      follow-up were evaluated. Two different methods were used to estimate the MCIDs: 
      distribution-based and anchor-based approaches (the latter used receiver 
      operating characteristic analysis). RESULTS: Using distribution-based methods, 
      the MCIDs of the DASH questionnaire were 7.4 and 8.3 by half standard deviation 
      and the 90% interval of minimal detectable change, respectively. By anchor-based 
      method (receiver operating characteristic analysis), the MCID was 8.3. 
      CONCLUSION: The MCID values calculated by each method validates that the results 
      for upper extremity oncology patients were similar to those reported in other 
      orthopedic conditions. These results identify the threshold for meaningful 
      improvements in DASH scores in orthopedic oncology patients and establish the 
      reference to evaluate health-related quality of life and the outcomes of upper 
      extremity oncology surgery. These data should be further refined for disease- and 
      reconstruction-specific analyses.
CI  - Copyright (c) 2021 Journal of Shoulder and Elbow Surgery Board of Trustees. 
      Published by Elsevier Inc. All rights reserved.
FAU - Ogura, Koichi
AU  - Ogura K
AD  - Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer 
      Center, New York, NY, USA.
FAU - Yakoub, Mohamed A
AU  - Yakoub MA
AD  - Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer 
      Center, New York, NY, USA.
FAU - Christ, Alexander B
AU  - Christ AB
AD  - Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer 
      Center, New York, NY, USA.
FAU - Fujiwara, Tomohiro
AU  - Fujiwara T
AD  - Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer 
      Center, New York, NY, USA.
FAU - Nikolic, Zarko
AU  - Nikolic Z
AD  - Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer 
      Center, New York, NY, USA.
FAU - Boland, Patrick J
AU  - Boland PJ
AD  - Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer 
      Center, New York, NY, USA.
FAU - Athanasian, Edward A
AU  - Athanasian EA
AD  - Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer 
      Center, New York, NY, USA.
FAU - Healey, John H
AU  - Healey JH
AD  - Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer 
      Center, New York, NY, USA. Electronic address: healeyj@mskcc.org.
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20210120
PL  - United States
TA  - J Shoulder Elbow Surg
JT  - Journal of shoulder and elbow surgery
JID - 9206499
SB  - IM
MH  - Arm
MH  - Disability Evaluation
MH  - Humans
MH  - Outcome Assessment, Health Care
MH  - *Quality of Life
MH  - Retrospective Studies
MH  - *Shoulder/surgery
MH  - Surveys and Questionnaires
MH  - Upper Extremity/surgery
PMC - PMC8289920
MID - NIHMS1666685
OTO - NOTNLM
OT  - DASH
OT  - MODEMS
OT  - minimal clinically important difference
OT  - patient-reported outcome measures
OT  - quality of life
OT  - sarcoma
OT  - surveys and questionnaires
OT  - upper extremity
COIS- CONFLICT OF INTEREST STATEMENT The authors have no conflicts of interest. No 
      benefits in any form have been received or will be received from a commercial 
      party related directly or indirectly to the subject of this article.
EDAT- 2021/01/24 06:00
MHDA- 2021/08/24 06:00
PMCR- 2022/09/01
CRDT- 2021/01/23 20:09
PHST- 2020/06/09 00:00 [received]
PHST- 2020/11/23 00:00 [revised]
PHST- 2020/11/25 00:00 [accepted]
PHST- 2021/01/24 06:00 [pubmed]
PHST- 2021/08/24 06:00 [medline]
PHST- 2021/01/23 20:09 [entrez]
PHST- 2022/09/01 00:00 [pmc-release]
AID - S1058-2746(21)00018-5 [pii]
AID - 10.1016/j.jse.2020.11.027 [doi]
PST - ppublish
SO  - J Shoulder Elbow Surg. 2021 Sep;30(9):e602-e609. doi: 10.1016/j.jse.2020.11.027. 
      Epub 2021 Jan 20.