Responsiveness and minimal important change of the QuickDASH and PSFS when used among patients with shoulder pain

Abstract

Background: The Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) and the Patient-Specific Functional Scale (PSFS) are commonly used outcome instruments for measuring self-reported disability in patients with shoulder pain. To date, few studies have evaluated the responsiveness and estimated their minimal important change (MIC). Further assessment will expand the current knowledge and improve the interpretability of these instruments in clinical and research practice. The purpose of this prospective cohort study with 3 months follow-up was to evaluate the responsiveness of the QuickDASH and PSFS in patients with shoulder pain, and to estimate their MICs by using two different anchor-based methods. Methods: Patients with shoulder pain recruited at a multidisciplinary hospital outpatient clinic completed the QuickDASH and PSFS at baseline and at 3 months follow-up. The responsiveness was evaluated by using a criterion approach with the area under the receiver operating characteristic curve (AUC) and a construct approach by testing 9 a-priori hypotheses. The MIC was assessed using two anchor-based MIC methods. Results: 134 patients participated at baseline and 117 (87.3%) at 3 months follow-up. The AUC was acceptable for both QuickDASH (0.75) and PSFS (0.75). QuickDASH met 7 (77.8%) and PSFS 8 (88.9%) of the hypotheses. None of the instruments showed signs of floor and ceiling effects. The MIC estimates ranged from 10.8 to 13.6 for QuickDASH and from 1.9 to 2.0 for PSFS, depending on the method used. Conclusion: This study demonstrates that both the QuickDASH and PSFS are responsive measures of disability in patients with shoulder pain. The estimated MIC values were presented.

A comparison between measurement properties of four shoulder-related outcome measures in Nepalese patients with shoulder pain

“…The results are also consistent with testing of the PSFS-NP in other areas of musculoskeletal pain (ICC = 0.75, r = 0.32 & 0.47) [16] providing strong evidence for the versatility of the PSFS-NP in a Nepali context. The result of the responsiveness testing was sufficient with values of AUC (0.83) similar or higher than previously reported (AUC = 0.67, 0.75, & 0.83) [13,26,27] and suggests the PSFS-NP is a good option to assess change in physical function in Nepalese adults with shoulder pain.…”

“…The DASH-NP, QuickDASH-NP and the SPADI-NP have all demonstrated sufficient reliability and validity while responsiveness testing suggests that PSFS-NP is the most responsive with a higher AUC value (0.83) than the other three shoulder PROMs. Previous studies have reported lower responsiveness for the PSFS-NP than other shoulder-related instruments [13,27]. A suggested explanation is that the PSFS-NP is both patient and function specific.…”

Asynchronous and Tailored Digital Rehabilitation of Chronic Shoulder Pain: A Prospective Longitudinal Cohort Study

“…The mean overall change of QuickDASH was 13.45 points (95% CI: 11.99; 14.92, Table 2 ), at a rate of 1.61 points per week (SD 1.40), representing a 51.6% recovery from baseline (p < 0.001, Supplementary Table S3 and Figure 2 ). Importantly, considering the MCID of 30% for QuickDASH, 57 results show an odds ratio (OR) of 3.06, corresponding to 75.4% probability of a participant being a responder (p < 0.001, Supplementary Table S7A ).…”

“… 56 An improvement of 30% was chosen as the minimal clinically important difference (MCID). 57 Secondary outcome measures included: – Numerical Pain Rating Scale (NPRS) through the question “Please rate your pain over the last 7 days: 0 (no pain at all) to 10 (worst pain imaginable)”. – Analgesic usage, assessed through the question: “Are you currently taking any pain medication?”.…”

Patients with subacromial pain in primary care : Assessment and efficacy of physiotherapy-guided exercise treatment

“…The PSFS is a reliable, valid and responsive instrument for patients with shoulder pain 84 . PSFS have been reported with an effect size (ES) of 0.7-0.9 132 , an area under the curve (AUC) of 0.67-0.76 84,132 , and a MIC of 1.29-2.0 points 84,132 with a sensitivity of 71% and specificity of 0.67 132 .…”