Cross-cultural adaptation of the disabilities of the arm, shoulder, and hand (DASH) questionnaire into Hungarian and investigation of its validity in patients with systemic sclerosis

• Published in: Clinical and experimental rheumatology Vol. 26; no. 5; pp. 776 - 783
• Main Authors: VARJU, C, BALINT, Z, SOLYOM, A. I, FARKAS, H, KARPATI, E, BERTA, B, KUMANOVICS, G, CZIRJAK, L, NAGY, Z
• Format: Journal Article
• Language: English
• Published: Pisa Clinical and Experimental Rheumatology 01-09-2008
• Subjects: Aged; Biological and medical sciences; Cultural Competency; Disease Progression; Diseases of the osteoarticular system; Female; Humans; Hungary; Male; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Scleroderma, Localized - diagnosis; Scleroderma, Systemic - diagnosis; Sensitivity and Specificity; Severity of Illness Index; Upper Extremity - physiopathology; Hungary; Human; Immunopathology; Connective tissue disease; Skin disease; Questionnaire; Rheumatology; sensitivity to change; Autoimmune disease; Hand; DASH; QuickDASH; functional assessment questionnaire; Quality of life; Disability; Validity; Sensitivity; Shoulder; Systemic sclerosis; Systemic disease; Scleroderma; Arm; validation; Adaptation
• ISSN: 0392-856X; 1593-098X

To adapt and validate the Hungarian version of the DASH and the shorter QuickDASH Outcome Measures and to establish their validity in patients with systemic sclerosis (SSc).
The Hungarian adaptation of the questionnaires was performed using forward/backward translations, expert and lay reviews. 128 patients completed the DASH, the Health Assessment Questionnaire (HAQ-DI), the Modified HAQ-DI for patients with SSc (SSc-HAQ), and the Short Form Health Survey (SF-36) questionnaire. 76 patients participated in a 12-month follow-up examination. Sensitivity to change was estimated using the standardized response mean (SRM).
Cronbach alpha in the DASH sections were between 0.94-0.97. The intraclass correlation coefficient for the test-retest reliability of DASH was 0.89. DASH scores showed a correlation with both SSc-HAQ and the physical dimensions of the SF-36 (Spearman's rho: 0.89, -0.77 and -0.42, respectively). The SRM of DASH was 0.64 among the scleroderma patients with worsening HAQ-DI status.
The Hungarian version of the DASH and QuickDASH demonstrated equivalent reproducibility, internal consistency and validity to the originals. The strong correlations of the DASH and QuickDASH with the HAQ-DI, and with the physical dimensions of the SF-36 show that the disability of the patient with SSc is predominantly caused by the functional impairment of the upper limb. Because both questionnaires were valuable tools for measuring upper extremity function and joint damage in SSc patients, we recommend the shorter and simpler QuickDASH for everyday clinical use.