TY - JOUR
T1 - Rasch analysis of the Disabilities of the Arm, Shoulder and Hand (DASH) instrument in patients with a humeral shaft fracture
AU - HUMMER Investigators
AU - Van Lieshout, Esther M.M.
AU - Mahabier, Kiran C.
AU - Tuinebreijer, Wim E.
AU - Verhofstad, Michael H.J.
AU - Den Hartog, Dennis
AU - Bolhuis, Hugo W.
AU - Bos, P. Koen
AU - Bronkhorst, Maarten W.G.A.
AU - Bruijninckx, Milko M.M.
AU - De Haan, Jeroen
AU - Deenik, Axel R.
AU - Den Hoed, P. Ted
AU - Eversdijk, Martin G.
AU - Goslings, J. Carel
AU - Haverlag, Robert
AU - Heetveld, Martin J.
AU - Kerver, Albertus J.H.
AU - Kolkman, Karel A.
AU - Leenhouts, Peter A.
AU - Meylaerts, Sven A.G.
AU - Onstenk, Ron
AU - Poeze, Martijn
AU - Poolman, Rudolf W.
AU - Punt, Bas J.
AU - Ritchie, Ewan D.
AU - Roerdink, W. Herbert
AU - Roukema, Gert R.
AU - Sintenie, Jan Bernard
AU - Soesman, Nicolaj M.R.
AU - Ten Holder, Edgar J.T.
AU - Van der Elst, Maarten
AU - Van der Heijden, Frank H.W.M.
AU - Van der Linden, Frits M.
AU - Van der Zwaal, Peer
AU - Van Dijk, Jan P.
AU - Van Jonbergen, Hans Peter W.
AU - Verleisdonk, Egbert J.M.M.
AU - Vroemen, Jos P.A.M.
AU - Waleboer, Marco
AU - Wittich, Philippe
AU - Zuidema, Wietse P.
AU - Al Khanim, Ahmed
AU - Bousema, Jelle E.
AU - Cheng, Kevin
AU - Claes, Yordy
AU - Cnossen, J. Daniël
AU - Dekker, Emmelie N.
AU - De Zwart, Aron J.M.
AU - Jawahier, Priscilla A.
AU - Joling, Boudijn S.H.
N1 - Funding Information: This work was funded by a grant from the Osteosynthesis and Trauma Care Foundation (reference no. 2013-DHEL). The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. Publisher Copyright: © 2019 Journal of Shoulder and Elbow Surgery Board of Trustees Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/5
Y1 - 2020/5
N2 - Background: The Disabilities of the Arm, Shoulder and Hand (DASH) instrument was developed to assess the disability experienced by patients with any musculoskeletal condition of the upper extremity and to monitor change in symptoms and upper-limb function over time. The 30 items are scored on a 5-point rating scale. The Dutch-language version of the DASH instrument (DASH-DLV) has been examined with the classical test theory in patients with a humeral shaft fracture. This study aimed to examine the DASH-DLV with a more rigorous and extensive analysis by applying the Rasch model. Methods: Data of 400 patients included in a multicenter, prospective study comparing operative and nonoperative treatment of adult patients with a humeral shaft fracture were used. The person-item map, item fit statistics, reliability, response category ordering, and dimensionality were examined. Raw data were converted to linear measures using the Rasch model. Results: The DASH-DLV showed a good fit to the Rasch model, except for item 26 (“Tingling [pins and needles] in your arm, shoulder or hand”). The person reliability was 0.92. In general, the category functioning of the 5-point rating scale was working well. Dimensionality analysis revealed that the DASH-DLV is a unidimensional scale. Differential item functioning for sex was not detected, and only item 26 exhibited differential item functioning as a function for age. Conclusion: The DASH-DLV fits the stringent Rasch model in a clinical situation with a group of adult patients with a humeral shaft fracture. Adequate measurement for scientific research can be obtained to evaluate longitudinal intervention research.
AB - Background: The Disabilities of the Arm, Shoulder and Hand (DASH) instrument was developed to assess the disability experienced by patients with any musculoskeletal condition of the upper extremity and to monitor change in symptoms and upper-limb function over time. The 30 items are scored on a 5-point rating scale. The Dutch-language version of the DASH instrument (DASH-DLV) has been examined with the classical test theory in patients with a humeral shaft fracture. This study aimed to examine the DASH-DLV with a more rigorous and extensive analysis by applying the Rasch model. Methods: Data of 400 patients included in a multicenter, prospective study comparing operative and nonoperative treatment of adult patients with a humeral shaft fracture were used. The person-item map, item fit statistics, reliability, response category ordering, and dimensionality were examined. Raw data were converted to linear measures using the Rasch model. Results: The DASH-DLV showed a good fit to the Rasch model, except for item 26 (“Tingling [pins and needles] in your arm, shoulder or hand”). The person reliability was 0.92. In general, the category functioning of the 5-point rating scale was working well. Dimensionality analysis revealed that the DASH-DLV is a unidimensional scale. Differential item functioning for sex was not detected, and only item 26 exhibited differential item functioning as a function for age. Conclusion: The DASH-DLV fits the stringent Rasch model in a clinical situation with a group of adult patients with a humeral shaft fracture. Adequate measurement for scientific research can be obtained to evaluate longitudinal intervention research.
KW - Basic Science Study
KW - PROMs
KW - Validation of Outcome Instrument
KW - fracture
KW - humerus
KW - outcome
KW - reliability
KW - validity
UR - http://www.scopus.com/inward/record.url?scp=85075895804&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jse.2019.09.026
DO - https://doi.org/10.1016/j.jse.2019.09.026
M3 - Article
C2 - 31786010
SN - 1058-2746
VL - 29
SP - 1040
EP - 1049
JO - Journal of shoulder and elbow surgery
JF - Journal of shoulder and elbow surgery
IS - 5
ER -