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The study reveals that some DASH items do not fit the underlying trait that the DASH aims to measure. Further studies using Rasch analysis are needed to compare our findings with results of studies involving other target groups (e.g. patients with injuries of the upper arm and shoulder).

Introduction. The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Hand Conditions has been developed as a tool to describe functioning in individuals with hand conditions. The purpose of this study was to validate the ICF Core Set in a multicentre study in Germany. Methods. We conducted a cross-sectional multicentre study involving individuals with various types of hand injuries or disorders from hand trauma units and rehabilitation facilities in Germany. We performed structured patient interviews using the Comprehensive ICF Core Set for Hand Conditions to investigate whether all of its categories are necessary to describe patients' functioning. Patients additionally completed the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH).Results. The study sample comprised 260 individuals (65% men) with a mean age of 46 years. Participants had a mean DASH score of 42.7 (22.25 SD) and a median time since injury or diagnosis of 106 days. Most frequent diagnoses were fractures at forearm, wrist and hand level. We identified patients' problems in all ICF categories of the Comprehensive ICF Core Set for Hand Conditions with a prevalence of at least 10%. Two ICF categories were perceived as missing: 'b4352 -functions of lymphatic vessels' and 'b298 -sensory functions and pain, other specified -neuralgia in upper extremity'. Discussion. The Comprehensive ICF Core Set for Hand Conditions has been validated in this national multicentre study. All of its categories could thereby be confirmed. Further validation is needed, involving different study samples in different countries worldwide.

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Timely identification of patients' problems after disorder or injury of the hand requires a thorough functional assessment. However, the variety of outcome measures available makes it difficult to choose the appropriate instrument. The brief International Classification of Functioning, Disability and Health (Brief ICF Core Set for Hand Conditions) provides a standard for what aspects need to be measured in hand injuries and disorders without specifying how to make the assessment. We developed the ICF-based Assessment Hand (ICF Hand), an assessment set for functioning based on the Brief ICF Core Set for Hand Conditions. First, we performed a literature review and an expert survey to pool outcome measures appropriate to assess functioning in clinical practice. At an interdisciplinary consensus conference experts decided on the outcome measures to be included in the ICF Hand. The ICF Hand provides a consensus on outcome measures and instruments to systematically assess function in patients with hand injuries and disorders.