Reliability, validity, responsiveness, and minimal important change of the Disablities of the Arm, Shoulder and Hand and Constant-Murley scores in patients with a humeral shaft fracture

Kiran C. Mahabier, Dennis Den Hartog, Nina Theyskens, Michael H.J. Verhofstad, Esther M.M. Van Lieshout, on behalf of show the HUMMER Trial Investigators

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background The Disabilities of the Arm, Shoulder and Hand (DASH) and Constant-Murley scores are commonly used instruments. The DASH is patient-reported, and the Constant-Murley combines a clinician-reported and a patient-reported part. For patients with a humeral shaft fracture, their validity, reliability, responsiveness, and minimal important change (MIC) have not been published. This study evaluated the measurement properties of these instruments in patients who sustained a humeral shaft fracture. Methods The DASH and Constant-Murley instruments were completed 5 times until 1 year after trauma. Pain score, Short Form 36, and EuroQol-5D were completed for comparison. Internal consistency was determined by the Cronbach α. Construct and longitudinal validity were evaluated by assessing hypotheses about expected Spearman rank correlations in scores and change scores, respectively, between patient-reported outcome measures (sub)scales. The smallest detectable change (SDC) was calculated. The MIC was determined using an anchor-based approach. The presence of floor and ceiling effects was determined. Results A total of 140 patients were included. Internal consistency was sufficient for DASH (Cronbach α = 0.96) but was insufficient for Constant-Murley (α = 0.61). Construct and longitudinal validity were sufficient for both patient-reported outcome measures (>75% of correlations hypothesized correctly). The MIC and SDC were 6.7 (95% confidence interval, 5.0-15.8) and 19.0 (standard error of measurement, 6.9), respectively, for DASH and 6.1 (95% CI −6.8 to 17.4) and 17.7 (standard error of measurement, 6.4), respectively, for Constant-Murley. Conclusions The DASH and Constant-Murley are valid instruments for evaluating outcome in patients with a humeral shaft fracture. Reliability was only shown for the DASH, making this the preferred instrument. The observed MIC and SDC values provide a basis for sample size calculations for future research.

Original languageEnglish
Pages (from-to)e1-e12
JournalJournal of Shoulder and Elbow Surgery
Volume26
Issue number1
DOIs
Publication statusPublished - 1 Jan 2017

Cite this

Mahabier, Kiran C. ; Den Hartog, Dennis ; Theyskens, Nina ; Verhofstad, Michael H.J. ; Van Lieshout, Esther M.M. ; on behalf of show the HUMMER Trial Investigators. / Reliability, validity, responsiveness, and minimal important change of the Disablities of the Arm, Shoulder and Hand and Constant-Murley scores in patients with a humeral shaft fracture. In: Journal of Shoulder and Elbow Surgery. 2017 ; Vol. 26, No. 1. pp. e1-e12.
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title = "Reliability, validity, responsiveness, and minimal important change of the Disablities of the Arm, Shoulder and Hand and Constant-Murley scores in patients with a humeral shaft fracture",
abstract = "Background The Disabilities of the Arm, Shoulder and Hand (DASH) and Constant-Murley scores are commonly used instruments. The DASH is patient-reported, and the Constant-Murley combines a clinician-reported and a patient-reported part. For patients with a humeral shaft fracture, their validity, reliability, responsiveness, and minimal important change (MIC) have not been published. This study evaluated the measurement properties of these instruments in patients who sustained a humeral shaft fracture. Methods The DASH and Constant-Murley instruments were completed 5 times until 1 year after trauma. Pain score, Short Form 36, and EuroQol-5D were completed for comparison. Internal consistency was determined by the Cronbach α. Construct and longitudinal validity were evaluated by assessing hypotheses about expected Spearman rank correlations in scores and change scores, respectively, between patient-reported outcome measures (sub)scales. The smallest detectable change (SDC) was calculated. The MIC was determined using an anchor-based approach. The presence of floor and ceiling effects was determined. Results A total of 140 patients were included. Internal consistency was sufficient for DASH (Cronbach α = 0.96) but was insufficient for Constant-Murley (α = 0.61). Construct and longitudinal validity were sufficient for both patient-reported outcome measures (>75{\%} of correlations hypothesized correctly). The MIC and SDC were 6.7 (95{\%} confidence interval, 5.0-15.8) and 19.0 (standard error of measurement, 6.9), respectively, for DASH and 6.1 (95{\%} CI −6.8 to 17.4) and 17.7 (standard error of measurement, 6.4), respectively, for Constant-Murley. Conclusions The DASH and Constant-Murley are valid instruments for evaluating outcome in patients with a humeral shaft fracture. Reliability was only shown for the DASH, making this the preferred instrument. The observed MIC and SDC values provide a basis for sample size calculations for future research.",
keywords = "Constant-Murley, DASH, Humeral shaft fracture, measurement properties, patient reported outcome measure, reliability, responsiveness, validity",
author = "Mahabier, {Kiran C.} and {Den Hartog}, Dennis and Nina Theyskens and Verhofstad, {Michael H.J.} and {Van Lieshout}, {Esther M.M.} and Bos, {P. Koen} and Bronkhorst, {Maarten W.G.A.} and Bruijninckx, {Milko M.M.} and {De Haan}, Jeroen and {Den Hoed}, {P. Ted} and Eversdijk, {Martin G.} and Goslings, {J. Carel} and Robert Haverlag and Heetveld, {Martin J.} and Kerver, {Albert J.H.} and Kolkman, {Karel A.} and Leenhouts, {Peter A.} and Meylaerts, {Sven A.G.} and Ron Onstenk and Martijn Poeze and Poolman, {Rudolf W.} and Punt, {Bas J.} and Ritchie, {Ewan D.} and Roerdink, {W. Herbert} and Roukema, {Gert R.} and Sintenie, {Jan Bernard} and Soesman, {Nicolaj M.R.} and {Van der Elst}, Maarten and {Van der Heijden}, {Frank H.W.M.} and {Van der Linden}, {Frits M.} and {Van der Zwaal}, Peer and {Van Dijk}, {Jan P.} and {Van Jonbergen}, {Hans Peter W.} and Verleisdonk, {Egbert J.M.M.} and Vroemen, {Jos P.A.M.} and Marco Waleboer and Philippe Wittich and Zuidema, {Wietse P.} and {on behalf of show the HUMMER Trial Investigators}",
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Reliability, validity, responsiveness, and minimal important change of the Disablities of the Arm, Shoulder and Hand and Constant-Murley scores in patients with a humeral shaft fracture. / Mahabier, Kiran C.; Den Hartog, Dennis; Theyskens, Nina; Verhofstad, Michael H.J.; Van Lieshout, Esther M.M.; on behalf of show the HUMMER Trial Investigators.

In: Journal of Shoulder and Elbow Surgery, Vol. 26, No. 1, 01.01.2017, p. e1-e12.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Reliability, validity, responsiveness, and minimal important change of the Disablities of the Arm, Shoulder and Hand and Constant-Murley scores in patients with a humeral shaft fracture

AU - Mahabier, Kiran C.

AU - Den Hartog, Dennis

AU - Theyskens, Nina

AU - Verhofstad, Michael H.J.

AU - Van Lieshout, Esther M.M.

AU - Bos, P. Koen

AU - Bronkhorst, Maarten W.G.A.

AU - Bruijninckx, Milko M.M.

AU - De Haan, Jeroen

AU - Den Hoed, P. Ted

AU - Eversdijk, Martin G.

AU - Goslings, J. Carel

AU - Haverlag, Robert

AU - Heetveld, Martin J.

AU - Kerver, Albert J.H.

AU - Kolkman, Karel A.

AU - Leenhouts, Peter A.

AU - Meylaerts, Sven A.G.

AU - Onstenk, Ron

AU - Poeze, Martijn

AU - Poolman, Rudolf W.

AU - Punt, Bas J.

AU - Ritchie, Ewan D.

AU - Roerdink, W. Herbert

AU - Roukema, Gert R.

AU - Sintenie, Jan Bernard

AU - Soesman, Nicolaj M.R.

AU - Van der Elst, Maarten

AU - Van der Heijden, Frank H.W.M.

AU - Van der Linden, Frits M.

AU - Van der Zwaal, Peer

AU - Van Dijk, Jan P.

AU - Van Jonbergen, Hans Peter W.

AU - Verleisdonk, Egbert J.M.M.

AU - Vroemen, Jos P.A.M.

AU - Waleboer, Marco

AU - Wittich, Philippe

AU - Zuidema, Wietse P.

AU - on behalf of show the HUMMER Trial Investigators

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background The Disabilities of the Arm, Shoulder and Hand (DASH) and Constant-Murley scores are commonly used instruments. The DASH is patient-reported, and the Constant-Murley combines a clinician-reported and a patient-reported part. For patients with a humeral shaft fracture, their validity, reliability, responsiveness, and minimal important change (MIC) have not been published. This study evaluated the measurement properties of these instruments in patients who sustained a humeral shaft fracture. Methods The DASH and Constant-Murley instruments were completed 5 times until 1 year after trauma. Pain score, Short Form 36, and EuroQol-5D were completed for comparison. Internal consistency was determined by the Cronbach α. Construct and longitudinal validity were evaluated by assessing hypotheses about expected Spearman rank correlations in scores and change scores, respectively, between patient-reported outcome measures (sub)scales. The smallest detectable change (SDC) was calculated. The MIC was determined using an anchor-based approach. The presence of floor and ceiling effects was determined. Results A total of 140 patients were included. Internal consistency was sufficient for DASH (Cronbach α = 0.96) but was insufficient for Constant-Murley (α = 0.61). Construct and longitudinal validity were sufficient for both patient-reported outcome measures (>75% of correlations hypothesized correctly). The MIC and SDC were 6.7 (95% confidence interval, 5.0-15.8) and 19.0 (standard error of measurement, 6.9), respectively, for DASH and 6.1 (95% CI −6.8 to 17.4) and 17.7 (standard error of measurement, 6.4), respectively, for Constant-Murley. Conclusions The DASH and Constant-Murley are valid instruments for evaluating outcome in patients with a humeral shaft fracture. Reliability was only shown for the DASH, making this the preferred instrument. The observed MIC and SDC values provide a basis for sample size calculations for future research.

AB - Background The Disabilities of the Arm, Shoulder and Hand (DASH) and Constant-Murley scores are commonly used instruments. The DASH is patient-reported, and the Constant-Murley combines a clinician-reported and a patient-reported part. For patients with a humeral shaft fracture, their validity, reliability, responsiveness, and minimal important change (MIC) have not been published. This study evaluated the measurement properties of these instruments in patients who sustained a humeral shaft fracture. Methods The DASH and Constant-Murley instruments were completed 5 times until 1 year after trauma. Pain score, Short Form 36, and EuroQol-5D were completed for comparison. Internal consistency was determined by the Cronbach α. Construct and longitudinal validity were evaluated by assessing hypotheses about expected Spearman rank correlations in scores and change scores, respectively, between patient-reported outcome measures (sub)scales. The smallest detectable change (SDC) was calculated. The MIC was determined using an anchor-based approach. The presence of floor and ceiling effects was determined. Results A total of 140 patients were included. Internal consistency was sufficient for DASH (Cronbach α = 0.96) but was insufficient for Constant-Murley (α = 0.61). Construct and longitudinal validity were sufficient for both patient-reported outcome measures (>75% of correlations hypothesized correctly). The MIC and SDC were 6.7 (95% confidence interval, 5.0-15.8) and 19.0 (standard error of measurement, 6.9), respectively, for DASH and 6.1 (95% CI −6.8 to 17.4) and 17.7 (standard error of measurement, 6.4), respectively, for Constant-Murley. Conclusions The DASH and Constant-Murley are valid instruments for evaluating outcome in patients with a humeral shaft fracture. Reliability was only shown for the DASH, making this the preferred instrument. The observed MIC and SDC values provide a basis for sample size calculations for future research.

KW - Constant-Murley

KW - DASH

KW - Humeral shaft fracture

KW - measurement properties

KW - patient reported outcome measure

KW - reliability

KW - responsiveness

KW - validity

UR - http://www.scopus.com/inward/record.url?scp=84994430543&partnerID=8YFLogxK

U2 - 10.1016/j.jse.2016.07.072

DO - 10.1016/j.jse.2016.07.072

M3 - Article

VL - 26

SP - e1-e12

JO - Journal of Shoulder and Elbow Surgery

JF - Journal of Shoulder and Elbow Surgery

SN - 1058-2746

IS - 1

ER -