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The Critical Difference in the DASH Outcome Measure After Essential Upper Extremity Tumor Surgery.

Abstract：

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 is useful for the interpretation of scores by defining the smallest change that a patient would perceive. However, the minimal clinically important differences of the scores in orthopedic oncology patients has not been reported. We aimed to determine the minimal clinically important differences 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 two surveys during postoperative follow-up were evaluated. Two different methods were used to estimate the minimal clinically important differences: distribution-based and anchor-based approaches (the latter utilized receiver operating characteristic analysis). RESULTS:Using distribution-based methods, the minimal clinically important differences 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 minimal clinically important difference was 8.3. CONCLUSION:The minimal clinically important difference 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. LEVEL OF EVIDENCE:Basic Science Study; Validation of Outcome Instrument.

journal_name

J Shoulder Elbow Surg

journal_title

Journal of shoulder and elbow surgery

authors

Ogura K,Yakoub MA,Christ AB,Fujiwara T,Nikolic Z,Boland PJ,Athanasian EA,Healey JH

doi

10.1016/j.jse.2020.11.027

subject

Has Abstract

pub_date

2021-01-20 00:00:00

eissn

1058-2746

issn

1532-6500

pii

S1058-2746(21)00018-5

pub_type

杂志文章

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The Critical Difference in the DASH Outcome Measure After Essential Upper Extremity Tumor Surgery.