Responsiveness of a 1-Year Recall Modified DASH Work Module in Active Workers with Upper Extremity Musculoskeletal Symptoms
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Objectives To evaluate the responsiveness to change of a modified version of the Work module of the Disabilities of the Arm, Shoulder, and Hand (DASH-W) in a prospective, longitudinal cohort study of active workers. Methods We compared change on a 1-year recall modified DASH-W to change on work ability, work productivity, and symptom severity, according to predetermined hypotheses following the Consensus-based standards for the selection of health measurement instruments (COSMIN). We evaluated concordance in the direction of change, and magnitude of change using Spearman rank correlations, effect sizes (ES), standardized response means (SRM), and area under the receiver operating characteristic curves (AUC). Results In a sample of 551 workers, change in 1-year recall modified DASH-W scores showed moderate correlations with changes in work ability, work productivity, and symptom severity (r = 0.47, 0.44, and 0.36, respectively). ES and SRM were moderate for 1-year recall modified DASH-W scores in workers whose work ability (ES = −0.58, SRM = −0.52) and work productivity improved (ES = −0.59, SRM = −0.56), and larger for workers whose work ability (ES = 1.24, SRM = 0.68) and work productivity worsened (ES = 1.02, SRM = 0.61). ES and SRM were small for 1-year recall modified DASH-W scores of workers whose symptom severity improved (−0.32 and −0.29, respectively). Responsiveness of the 1-year recall modified DASH-W was moderate for those whose symptom severity worsened (ES = 0.77, SRM = 0.50). AUC met responsiveness criteria for work ability and work productivity. Conclusions The 1-year recall modified DASH-W is responsive to changes in work ability and work productivity in active workers with upper extremity symptoms.
KeywordsOutcome measures Occupational injuries Psychometrics Musculoskeletal diseases Work
This study was supported by Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health (CDC/NIOSH) (Grant No: R01OH008017-01) and by the Washington University Institute of Clinical and Translational Sciences Award (CTSA) (Grant No: UL1 TR000448) from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH). This research was also supported (in part) by a pilot project research training grant from the Heartland Center for Occupational Health and Safety at the University of Iowa. The Heartland Center is supported by training Grant No: T42OH008491 from the CDC/NIOSH. The contents of the manuscript are solely the responsibility of the authors and do not necessarily represent the official view of NIOSH, NCATS, or NIH. All funding sources had no direct role in the study design, data collection, analysis and interpretation of data, writing of the manuscript, or decision to submit this work for publication. None of the study sponsors were involved in the development of this manuscript. The authors wish to thank members of the research team for their contributions to the preparation of this manuscript including Anna Kinghorn, Nina Smock, and Angelique Zeringue. The authors also wish to thank Dorcas Beaton and Carol Kennedy for their thoughtful insights regarding the study design.
Conflict of interest
Ann Marie Dale, Bethany T. Gardner, Skye Buckner-Petty, Jaime Strickland, Vicki Kaskutas, and Bradley Evanoff declare that they have no relevant conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants.
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