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

The disabilities of the arm, shoulder and hand (DASH) questionnaire is a se lf-administered region-specific outcome instrument developed to measure upp er-extremity disability and symptoms. The DASH consists mainly of a 30-item disability/symptom scale. We performed cross-cultural adaptation of the DA SH to Swedish, using a process that included double forward and backward tr anslations, expert and lay review as well as field-testing to achieve lingu istic and conceptual equivalence. The Swedish version's reliability and val idity were then evaluated in 176 patients with upper-extremity con ditions. The patients completed the DASH and SF-12 generic health questionnaire bef ore elective surgery or physical therapy. Internal consistency of the DASH was high (Cronbach alpha 0.96). Test-retest reliability, evaluated in a sub group 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 wi th the SF-12 scores (worse upper-extremity disability correlating with wors e general health), stronger correlation with the SF-12 physical than with t he mental health component, correlation of worse DASH scores with worse sel f-rated global health, and ability to discriminate among conditions known t o differ in severity. The Swedish version of the DASH is a reliable and val id instrument that can provide a standardized measure of patient-centered outcomes in upper extremity musculoskeletal conditions.