Purpose
It is unclear what score changes on the abbreviated Disabilities of the Arm, Hand,
and Shoulder (QuickDASH), Patient-Reported Outcomes Measurement Information System (PROMIS) upper extremity
(UE) computer adaptive test (CAT), and PROMIS physical function (PF) CAT represent
a substantial improvement. We calculated the substantial clinical benefit (SCB) for
these 3 instruments in a non-shoulder hand and upper extremity population.
Methods
Adult patients treated between March 2015 and September 2019 at a single academic
tertiary institution were identified. The QuickDASH, PROMIS UE CAT v2.0, and PROMIS PF CAT v2.0 scores were collected using a tablet
computer. Responses to the QuickDASH both at baseline and follow-up 6 ± 4 weeks later, and a response to the anchor
question “Compared to your first evaluation at the University Orthopaedic Center,
how would you describe your physical function level now?” were required for inclusion.
A second anchor question querying treatment-related improvement was also used. The
SCB was calculated using an anchor-based approach comparing the mean change difference
between groups reporting no change and a maximal change for both anchor questions.
Results
Of 1,119 included participants, the mean age was 48 ± 17 years, 53% were women, and
half were recovering from surgery. Score changes between baseline and follow-up were
significantly different between groups reporting no improvement and maximal improvement
on both anchor questions. The SCB values ranged between 16.9 and 22.8 on the QuickDASH, 5.9 and 7.1 on the UE CAT, and 3.5 and 6.7 on the PF CAT.
Conclusions
These score improvements for the QuickDASH, UE CAT, and PF CAT represent a substantial clinical improvement in a non-shoulder
hand and upper extremity population.
Clinical relevance
These SCB estimates may assist with the interpretation of outcome scores at a population
level.
Key words
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Article info
Publication history
Published online: February 21, 2022
Accepted:
December 29,
2021
Received:
January 26,
2021
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
