Linguistic validation, validity and reliability of the British English versions of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and QuickDASH in people with rheumatoid arthritis

Abstract

Background: Although the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is widely used in the

UK, no British English version is available. The aim of this study was to linguistically validate the DASH into British

English and then test the reliability and validity of the British English DASH, (including the Work and Sport/Music

DASH) and QuickDASH, in people with rheumatoid arthritis (RA).

Methods: The DASH was forward translated, reviewed by an expert panel and cognitive debriefing interviews

undertaken with 31 people with RA. Content validity was evaluated using the ICF Core Set for RA. Participants with

RA (n = 340) then completed the DASH, Health Assessment Questionnaire (HAQ), Short Form Health Survey v2

(SF36v2) and Measure of Activity Performance of the Hand (MAPHAND). We examined internal consistency and

concurrent validity for the DASH, Work and Sport/Music DASH modules and QuickDASH. Participants repeated the

DASH to assess test-retest reliability.

Results: Minor wording changes were made as required. The DASH addresses a quarter of Body Function and half

of Activities and Participation codes in the ICF RA Core Set. Internal consistency for DASH scales were consistent

with individual use (Cronbach’s alpha = 0.94–0.98). Concurrent validity was strong with the HAQ (rs = 0.69–0.91),

SF36v2 Physical Function (rs = − 0.71 - − 0.85), Bodily Pain (rs = − 0.71 - − 0.74) scales and MAPHAND (rs = 0.71–0.93).

Test-retest reliability was good (rs = 0.74–0.95).

Conclusions: British English versions of the DASH, QuickDASH and Work and Sport/Music modules are now

available to evaluate upper limb disabilities in the UK. The DASH, QuickDASH, Work and Sport/Music modules are

reliable and valid to use in clinical practice and research with British people with RA.

Keywords: Patient reported outcomes, Upper limb assessment, Rehabilitation, Rheumatoid arthritis