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Kleinlugtenbelt YV, Krol RG, Bhandari M, et al. Are the patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and hand (DASH) questionnaire used in distal radial fractures truly valid and reliable?. Bone Joint Res. 2018;7(1):36-45doi: 10.1302/2046-3758.71.BJR-2017-0081.R1.
Kleinlugtenbelt, Y. V., Krol, R. G., Bhandari, M., Goslings, J. C., Poolman, R. W., & Scholtes, V. A. B. (2018). Are the patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and hand (DASH) questionnaire used in distal radial fractures truly valid and reliable?. Bone & joint research, 7(1), 36-45. https://doi.org/10.1302/2046-3758.71.BJR-2017-0081.R1
Kleinlugtenbelt, Y V, et al. "Are the patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and hand (DASH) questionnaire used in distal radial fractures truly valid and reliable?." Bone & joint research vol. 7,1 (2018): 36-45. doi: https://doi.org/10.1302/2046-3758.71.BJR-2017-0081.R1
Kleinlugtenbelt YV, Krol RG, Bhandari M, Goslings JC, Poolman RW, Scholtes VAB. Are the patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and hand (DASH) questionnaire used in distal radial fractures truly valid and reliable?. Bone Joint Res. 2018 Jan;7(1):36-45. doi: 10.1302/2046-3758.71.BJR-2017-0081.R1. PMID: 29330342; PMCID: PMC5805831.
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Bone Joint Res. 2018 Jan;7(1):36-45. doi: 10.1302/2046-3758.71.BJR-2017-0081.R1.

Are the patient-rated wrist evaluation (PRWE) and the disabilities of the arm, shoulder and hand (DASH) questionnaire used in distal radial fractures truly valid and reliable?.

Bone & joint research

Y V Kleinlugtenbelt, R G Krol, M Bhandari, J C Goslings, R W Poolman, V A B Scholtes

Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Joint Research OLVG Oost, PO Box 95500, 1090 HM, Amsterdam, the Netherlands; Department of Orthopaedic and Trauma Surgery, Deventer Ziekenhuis, Nico Bolkesteinlaan 75, 7416 SE Deventer, the Netherlands; and Division of Ortopaedic Surgery, Department of Surgery, McMaster University, 1200 Main St, Hamilton, Ontario L8N 3Z5, Canada [email protected].
  2. Department of Orthopaedic and Trauma Surgery, Joint Research OLVG Oost, PO Box 95500, 1090 HM, Amsterdam, The Netherlands.
  3. Division of Orthopaedic Surgery, McMaster University, 1200 Main St. West, Room 4E17, Hamilton, Ontario L8N 3Z5, Canada.
  4. Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.

PMID: 29330342 PMCID: PMC5805831 DOI: 10.1302/2046-3758.71.BJR-2017-0081.R1

Abstract

OBJECTIVES: The patient-rated wrist evaluation (PRWE) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire are patient-reported outcome measures (PROMs) used for clinical and research purposes. Methodological high-quality clinimetric studies that determine the measurement properties of these PROMs when used in patients with a distal radial fracture are lacking. This study aimed to validate the PRWE and DASH in Dutch patients with a displaced distal radial fracture (DRF).

METHODS: The intraclass correlation coefficient (ICC) was used for test-retest reliability, between PROMs completed twice with a two-week interval at six to eight months after DRF. Internal consistency was determined using Cronbach's α for the dimensions found in the factor analysis. The measurement error was expressed by the smallest detectable change (SDC). A semi-structured interview was conducted between eight and 12 weeks after DRF to assess the content validity.

RESULTS: A total of 119 patients (mean age 58 years (sd 15)), 74% female, completed PROMs at a mean time of six months (sd 1) post-fracture. One overall meaningful dimension was found for the PRWE and the DASH. Internal consistency was excellent for both PROMs (Cronbach's α 0.96 (PRWE) and 0.97 (DASH)). Test-retest reliability was good for the PRWE (ICC 0.87) and excellent for the DASH (ICC 0.91). The SDC was 20 for the PRWE and 14 for the DASH. No floor or ceiling effects were found. The content validity was good for both questionnaires.

CONCLUSION: The PRWE and DASH are valid and reliable PROMs in assessing function and disability in Dutch patients with a displaced DRF. However, due to the high SDC, the PRWE and DASH are less useful for individual patients with a distal radial fracture in clinical practice.

© 2018 Kleinlugtenbelt et al.

Keywords: Disabilities of the Arm Shoulder and Hand (DASH) questionnaire; Distal radial fracture; Patient-rated wrist evaluation (PRWE); Reliability; Validity

Conflict of interest statement

Conflicts of Interest Statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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