lecture 6: the DASH Flashcards
what are the two main purposes of the DASH?
- describe different groups of people and discriminate between individuals/groups to compare impact of UE disorders
> discriminative measure - evaluate and assess changes over time related to natural history of disorder/effect of treatment interventions
> evaluative measure
what does the DASH include?
- 30-item questionnaire + 2 optional 4-item modules (measure impact of UE issues on writing, music, and sport)
what does the DAS measure?
the capacity to do a task NOT if they have performed it
how is the DASH administered?
- questionnaire
- circle appropriate responses to question in the PAST WEEK
> if did not do action in past week, asked to make best estimate - designed in paper/pencil format but also done on tablet
how is the DASH scored?
- disability/symptom score
- need to complete at least 27/30 items
- values summed and averaged to get score out of 5
- transform value to score out of 100
- higher score = higher disability - work/sports/music module
- need to do all 4 modules to get score
- add values and divide by 4
- transform to get a score out of 100
what happens if there is missing data in the DASH?
if >10% is missing (>3) = cannot calculate DASH score
what theories were used to develop the DASH?
- item generation - defines potential questions being considered to guide content of questionnaire
- done to identify items that fell outside targeted components - item reduction - eliminates redundant items to make number of questions feasible
- psychometric strategies - math techniques to make scale to measure single patient attributes (homogenous scale)
- clinimetric strategies - judgements of patients and clinicians to measure clinical phenomena that comprise several unrelated patient characteristics (heterogenous scale)
- disablement process
what is the clinical utility of the DASH w/ respect to specificity?
- in defining area of assessment…
- DASH considers that disability is not owed to a single anatomical site but instead kinetic chain
- centered on entire UE to benefit the busy clinic setting - in wording of questions…
- have non-attributed wording since concerned with overall performance of the task
what is the clinical utility of the DASH w/ respect to availiabity?
- downloaded from DASH website
- free
- common assessment
- available in many languages
- no set age limits (usually 18-65)
- used for acute and chronic conditions
what is the clinical utility of the DASH w/ respect to time and training demands?
- self-administered –> minimize observer bias
- time efficiency for health care providers
- 10-15 minutes + modules
what is the clinical utility of the DASH w/ respect to acceptability to clients?
- considers balance between length of measure and info collection in psychometrically sound way
- have condensed version
- use this one assessment for comparative measures for different conditions of upper limb - saving time and preventing fatigue
what is the clinical utility of the DASH w/ respect to cost?
- low administration costs
- free online
what is the clinical utility of the DASH w/ respect to cross-cultural validity?
- translated into 28 languages and look at relevance of each item to different cultures
- moderate to high construct validity scores
what are strengths of the DASH standardization?
- multiple languages
- used in original form without changes
- using single mesaure allows for standardized comparisons between different conditions
- normative data from large population survey available
what are limitations of the DASH standardization?
- no dialect variations
- designed to be competed in paper format (telephone admin not tested yet)
- may perceive intensity of items differently (ex. pain)
