PMID- 38438144
OWN - NLM
STAT- Publisher
LR  - 20240304
IS  - 1538-6724 (Electronic)
IS  - 0031-9023 (Linking)
DP  - 2024 Mar 4
TI  - Minimal Clinically Important Difference of the Disabilities of the Arm, Shoulder 
      and Hand (DASH) and the Shortened Version of the DASH (QuickDASH) in People with 
      Musculoskeletal Disorders: A Systematic Review and Meta-Analysis.
LID - pzae033 [pii]
LID - 10.1093/ptj/pzae033 [doi]
AB  - OBJECTIVE: The objective of this study was to perform a meta-analysis of the 
      minimal clinically important difference (MCID) of the Disabilities of the Arm, 
      Shoulder and Hand (DASH) questionnaire and its shortened version (ie, the 
      QuickDASH). METHODS: MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, Cochrane 
      Library, and Scopus were searched up to July 2022. Studies on people with upper 
      limb musculoskeletal disorders that calculated the MCID by anchor-based methods 
      were included. Descriptive and quantitative synthesis was used for the MCID and 
      the minimal detectable change with 90% confidence (MDC90). Fixed-effects models 
      and random-effect models were used for the meta-analysis. I2 statistics was 
      computed to assess heterogeneity. The methodological quality of studies was 
      assessed with the Consensus-Based Standards for the Selection of Health 
      Measurement Instruments checklist for measurement error and an adaptation of the 
      checklist for the MCID proposed by Bohannon & Glenney. RESULTS: Twelve studies 
      (1677 patients) were included, producing 17 MCID estimates ranging from 8.3 to 
      18.0 DASH points and 8.0 to 18.1 QuickDASH points. The pooled MCIDs were 11.00 
      DASH points (95% CI = 8.59 to 13.41; I2 = 0%) and 11.97 QuickDASH points (95% 
      CI = 9.60 to 14.33; I2 = 0%). The pooled MDC90s were 9.04 DASH points (95% 
      CI = 6.46 to 11.62; I2 = 0%) and 9.03 QuickDASH points (95% CI = 6.36 to 11.71; 
      I2 = 18%). Great heterogeneity was identified among the primary studies along 
      with important methodological problems in the calculation of the MCID. 
      CONCLUSION: Reasonable MCID ranges of 12 to 14 DASH points and 12 to 15 QuickDASH 
      points were established. The lower boundaries represent the first available 
      measure above the pooled MDC90, and the upper limits represent the upper 95% CI 
      of the pooled MCID. IMPACT: Reasonable ranges for the MCID of 12 to 14 DASH 
      points and 12 to 15 QuickDASH points were proposed. The lower boundaries 
      represent the first available measure above the pooled MDC90, and the upper 
      limits represent the upper 95% CI of the pooled MCID. Information regarding the 
      interpretability of the 2 questionnaires was derived from very different 
      methodologies, making it difficult to identify reliable thresholds. Now 
      clinicians and researchers can rely on more credible data. The MCID proposed 
      should be used to assess people with musculoskeletal disorders. Heterogeneity was 
      found related particularly to the anchor levels used in the primary studies. To 
      promote comparability of MCID values, shared rules defining the most appropriate 
      types of anchoring will be needed in the near future.
CI  - (c) The Author(s) 2024. Published by Oxford University Press on behalf of the 
      American Physical Therapy Association. All rights reserved. For permissions, 
      please e-mail: journals.permissions@oup.com.
FAU - Galardini, Lorenzo
AU  - Galardini L
AD  - Department of Human Neurosciences, Sapienza University of Roma, Rome, Italy.
FAU - Coppari, Andrea
AU  - Coppari A
AD  - Physical and Rehabilitation Medicine Unit, Azienda Sanitaria Territoriale, Jesi 
      (AN), Italy.
FAU - Pellicciari, Leonardo
AU  - Pellicciari L
AD  - IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
FAU - Ugolini, Alessandro
AU  - Ugolini A
AD  - Private Practice, Empoli (FI), Italy.
FAU - Piscitelli, Daniele
AU  - Piscitelli D
AD  - Department of Kinesiology, University of Connecticut, Storrs, CT, USA.
FAU - La Porta, Fabio
AU  - La Porta F
AD  - IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
FAU - Bravini, Elisabetta
AU  - Bravini E
AD  - Italian Society of Physiotherapy, Florence, Italy.
FAU - Vercelli, Stefano
AU  - Vercelli S
AD  - Rehabilitation Research Laboratory 2rLab, Department of Business Economics, 
      Health and Social Care, University of Applied Sciences and Arts of Southern 
      Switzerland, Manno, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20240304
PL  - United States
TA  - Phys Ther
JT  - Physical therapy
JID - 0022623
SB  - IM
OTO - NOTNLM
OT  - Clinical Relevance
OT  - Minimal Detectable Change
OT  - Patient Reported Outcome Measures
OT  - Psychometrics
OT  - Responsiveness
OT  - Upper Extremity
EDAT- 2024/03/05 00:45
MHDA- 2024/03/05 00:45
CRDT- 2024/03/04 20:33
PHST- 2023/08/01 00:00 [received]
PHST- 2023/10/30 00:00 [revised]
PHST- 2024/02/22 00:00 [accepted]
PHST- 2024/03/05 00:45 [medline]
PHST- 2024/03/05 00:45 [pubmed]
PHST- 2024/03/04 20:33 [entrez]
AID - 7619022 [pii]
AID - 10.1093/ptj/pzae033 [doi]
PST - aheadofprint
SO  - Phys Ther. 2024 Mar 4:pzae033. doi: 10.1093/ptj/pzae033.