DASH in action around the world

As part of our 20th anniversary celebration, we asked users to tell us how the DASH has made a difference in their research or clinical practice. Here's what users from across the globe have told us. We're always interested in hearing more stories like these. If you would like to send us stories of how the DASH Outcome Measure has made a difference to your practice, we would love to hear from you.

Using the DASH at KEM Hospital in Mumbai for clinical, research and teaching purposes

A staff member at the King Edward Memorial (KEM) Hospital and Seth G.S. Medical College helps a patient fill out the DASH Outcome Measure™ questionnaire

In our clinic, we use the DASH Outcome Measure™ for clinical documentation of patients undergoing physiotherapy of the hand, as well as for research purposes. We find it very useful for assessing the effectiveness of our treatment on patients. We use the original English version and the Hindi version for patient assessment. And we are eagerly waiting for the Marathi version of the questionnaire.

I incorporate the DASH Outcome Measure when I teach my undergraduate physical therapy students the International Classification of Functioning, Disability and Health (ICF) model. I tell them about the importance of the DASH Outcome Measure in clinical practice and research.

While inculcating the values of rehabilitation in their mind, I emphasize the fact that we, as physiotherapists, should aim to improve a patient’s capacity and performance, to enable him/her to return to work and society at near pre-injury level.

The clinical team at KEM Hospital’s Hands Section

I genuinely find the DASH Outcome Measure self-administrable, user-friendly, reliable, valid for a variety of upper limb musculoskeletal conditions and responsive to clinical change.

Professor Chhaya Verma

It’s designed to evaluate single/multiple disorders in the upper limb, and it has good correlation with the generic quality-of-life health measures and joint-specific measures used in upper limb conditions.

The DASH Outcome Measure is a most robust and extremely useful patient-rated upper extremity specific outcome measure. It facilitates meaningful analysis and demonstrates the value of clinical intervention (by a surgeon or therapist) to patients and to society at large.

Professor Chhaya Verma, Physiotherapy School & Centre
King Edward Memorial (KEM) Hospital & Seth G.S. Medical College
Mumbai, Maharashtra, India

How the DASH helps Arizona clinical professor identify specific problems and determine appropriate treatment

I use the DASH Outcome Measure™ and the QuickDASH with impairment measures such as range of motion, strength testing, etc. when the patient comes in for their initial assessment, and then at discharge to measure change over time (treatment outcome). I track patient progress with these assessment tools through the electronic medical record as a means to demonstrate treatment effectiveness to insurance companies.

I prefer using the QuickDASH over the DASH solely because the shorter 11-item QuickDASH is much more user-friendly. Patients are less resistant to completing the shorter version. The psychometric properties of the two assessments are similar, so using the shorter version is acceptable. The QuickDASH helps to identify problems that require intervention at an item level.

Dr. Sue Dahl-Popolizio

Both assessments are helpful when patients have difficulty articulating functional deficits; they identify specific activities the patient is struggling with.

As an OT, I can generalize that information to many functional tasks, which allows me to determine what the specific problem is and focus on that component of the task.

When I developed a population health management program, specifically for arthritis in the hand, I chose the QuickDASH because it’s well known, it’s short, and its psychometric properties support its use. The scoring system of the QuickDASH measure helped me stratify patients in appropriate level of care.

Dr. Sue Dahl-Popolizio, DBH, OTR/L, CHT
Clinical Assistant Professor, Arizona State University

Collecting patient outcomes made easy for DASH commercial license holder in B.C.

A report of DASH scores on the Ratchet Health portal

“Value-based quality care” is the buzzword for talking about health-care reform in today’s market. As physicians and surgeons, we have always wanted to provide the best care to our patients whether we are doing research or practicing in a small rural setting. Patient-reported outcomes such as DASH scores have made it easier for me to assure myself that my patients are doing well and to compare different research protocols.

A physical therapist holds the paper version of the DASH Outcome Measure™

So, why DASH Outcome Measure™ scores? Being able to collect data even when the patient isn’t there allows us to put more data points on the picture we are trying to paint of our practice.

We still need to measure things in person, but having the ability to follow patients over time regardless of their location, with the use of patient-reported outcomes, is powerful.

In addition, having a single tool that gives me data for all of my upper extremity patients is powerful. The fewer different things we give our patients to complete, the more reliable our data retrieval will be. Giving our patients one tool that gives us data from the fingers to the shoulder is powerful.

Dr. Sean Adelman, Orthopedic Surgeon and Platform Evangelist
Ratchet Health (holder of a DASH commercial licence)
www.ratchethealth.com

OT translates DASH to improve patient reporting of outcome measures in Bulgaria

Doctors and surgeons in Bulgaria have yet to embrace the idea of patient report outcome measures. Only recently has there been an interest in such measures, and they’re generally unavailable in the Bulgarian language. When I began working in the division of hand surgery in the main trauma hospital in Sofia, impairment measures were rarely used, and a patient report outcome measure for the upper extremity did not exist.

Physical therapist Johanna Jacobson-Petrov (second from left) is on a team-building retreat at a historic Bulgarian village with members, all surgeons, of the Division of Hand Surgery at the N.I. Pirogov University Hospital of Emergency Medicine

I wanted to do clinical research, but I had no way of measuring, from our patients’ perspectives, what impact our treatment was having on their level of function. There were a couple of instances where the DASH Outcome Measure™ was used for research within Bulgaria, but it was being used incorrectly. Surgeons were randomly translating the DASH just for their particular project and then presenting the results. Unfortunately, these results would be invalid since the instrument was not properly translated or adapted to the Bulgarian culture.

Our clinic took on the challenge of translating and culturally adapting the DASH in the hopes of having a patient report outcome measure to use for patients with upper extremity trauma or disease.

Johanna Jacobson-Petrov, BScOT, CHT, Division of Hand and Microsurgery
N.I. Pirogov, University Hospital of Emergency Medicine, Sofia, Bulgaria