The minimal important change for the QuickDASH in patients with thumb carpometacarpal arthritis

Abstract

Evaluating the effect of treatment through change in patient-reported outcomes requires an understanding of the minimal important change. The aim of this study was to report the minimal important change for the Quick Disability of the Arm, Shoulder and Hand questionnaire (QuickDASH) in patients receiving surgical treatment for thumb carpometacarpal joint osteoarthritis. Three hundred and fifteen patients were seen before and 6 months following surgery. Two methods were used to calculate the minimal important change: a distribution-based method calculating the standard error of measurement and an anchor-based method based on the receiver operating characteristic curve. The minimal important change for QuickDASH was estimated to be 18.2 points using the anchor-based method. The area under the receiver operating curve was 0.82, indicating a satisfactory accuracy. The minimal important change was estimated to be 10.3 points using the distribution-based method. These values may be useful in future research on thumb carpometacarpal joint osteoarthritis.

Level of evidence: III

Keywords

QuickDASH minimal clinical important difference patient-reported outcome measures thumb carpometacarpal joint osteoarthritis

Get full access to this article

View all access options for this article.

References

Brozek

Guyatt

Schunemann

. How a well-grounded minimal important difference can enhance transparency of labelling claims and improve interpretation of a patient reported outcome measure. Health Qual Life Outcomes. 2006, 4: 69.

Burton

Pellegrini

Jr . Surgical management of basal joint arthritis of the thumb. Part ii. Ligament reconstruction with tendon interposition arthroplasty. J Hand Surg Am. 1986, 11: 324–32.

Christiansen

Frost

Falla

Haahr

Frich

Svendsen

. Responsiveness and minimal clinically important change: a comparison between 2 shoulder outcome measures. J Orthop Sports Phys Ther. 2015, 45: 620–5.

Eaton

Glickel

. Trapeziometacarpal osteoarthritis. Staging as a rationale for treatment. Hand Clin. 1987, 3: 455–71.

Gervis

. Excision of the trapezium for osteoarthritis of the trapezio-metacarpal joint. J Bone Joint Surg Br. 1949, 31: 537–9, illust.

Health IfWa. Institute for Work and Health. 2020. https://dash.iwh.on.ca/sites/dash/public/translations/QuickDASH_Danish.pdf.

Herup

Merser

Boeckstyns

. [Validation of questionnaire for conditions of the upper extremity]. Ugeskr Laeger. 2010, 172: 3333–6.

Holmgren

Oberg

Adolfsson

Bjornsson Hallgren

Johansson

. Minimal important changes in the Constant-Murley score in patients with subacromial pain. J Shoulder Elbow Surg. 2014, 23: 1083–90.

Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (Disabilities of the Arm, Shoulder and Hand) [corrected]. The upper extremity collaborative group (UECG). Am J Ind Med. 1996, 29: 602–8.

10.

Kazmers

Qiu

Yoo

Stephens

Tyser

Zhang

. The minimal clinically important difference of the PROMIS and QuickDASH instruments in a nonshoulder hand and upper extremity patient population. J Hand Surg Am. 2020, 45: 399–407 e6.

11.

Marks

Grobet

Audigé

Herren

. Clinical thresholds of symptoms for deciding on surgery for trapeziometacarpal osteoarthritis. J Hand Surg Eur. 2019, 44: 937–45.

12.

Mintken

Glynn

Cleland

. Psychometric properties of the shortened disabilities of the arm, shoulder, and hand questionnaire (QuickDASH) and numeric pain rating scale in patients with shoulder pain. J Shoulder Elbow Surg. 2009, 18: 920–6.

13.

Polson

Reid

McNair

Larmer

. Responsiveness, minimal importance difference and minimal detectable change scores of the shortened disability arm shoulder hand (QuickDASH) questionnaire. Man Ther. 2010, 15: 404–7.

14.

Rodrigues

Mabvuure

Nikkhah

Shariff

Davis

. Minimal important changes and differences in elective hand surgery. J Hand Surg Eur. 2015, 40: 900–12.

15.

Smith-Forbes

Howell

Willoughby

Pitts

Uhl

. Specificity of the minimal clinically important difference of the quick disabilities of the arm shoulder and hand (QDASH) for distal upper extremity conditions. J Hand Ther. 2016, 29: 81–8; quiz 8.

16.

Sorensen

Howard

Tan

Ketchersid

Calfee

. Minimal clinically important differences of 3 patient-rated outcomes instruments. J Hand Surg Am. 2013, 38: 641–9.

17.

Tang

Giddins

. Why and how to report surgeons' levels of expertise. J Hand Surg Eur. 2016, 41: 365–6.

18.

Vermeulen

Slijper

Feitz

Hovius

Moojen

Selles

. Surgical management of primary thumb carpometacarpal osteoarthritis: a systematic review. J Hand Surg Am. 2011, 36: 157–69.

19.

Weilby

. Surgical treatment of osteoarthritis of the carpo-meta-carpal joint of the thumb. Acta Orthop Scand. 1971, 42: 439–40.

20.

Wejnold Jorgensen R, Odgaard A, Flensted F, Daugaard H, Hjorth Jensen C. Patient-reported outcomes following interposition arthroplasty of the basal joint of the thumb. J Plast Surg Hand Surg. 2020: 1–6.