172. Development and Psychometric Testing of a British English Version of the Disabilities Arm Shoulder and Hand Questionnaire
Bibliographic record
Abstract
Background: The Disabilities Arm Should and Hand (DASH) questionnaire (developed in Canada) is a widely used outcome measure for upper limb conditions, consisting of 30 items, 21 regarding daily activity and 9 regarding impact of condition. The aim of this study was to develop a British English DASH and psychometrically test it in a UK population of people with RA. Methods: The Institute of Work and Health (IWH) cross-cultural adaptation methods were followed: forward translation to British English; synthesis; expert review of equivalence; and cognitive debriefing. Psychometric testing included internal consistency (Cronbach’s α); test-retest reliability [ICC (2,1)] and concurrent validity (Pearson’s and Spearman’s correlations). Adults with RA were recruited from 17 Rheumatology outpatient departments, who completed two test booklets three weeks apart, including the DASH, HAQ20, SF36v2 and numeric rating scales for disease activity, hand pain, general pain and fatigue. Results: During translation and equivalence review, changes to use plain English and British English terminology were made (e.g. do not perform; jumper rather than pullover sweater). 31 people with RA were interviewed [age 63.42 (s.d. 12.04) years, RA duration 15.71 (s.d. 12.61) years]. All DASH items were considered understandable and relevant. 340 completed the test 1 booklet: 251 women, 89 men; mean age 62 (s.d. 12) years; RA duration 14.44 (s.d. 11.73) tears; average pain score = 5 (IQR 2–7) and 273 completed the retest. Reliability was good: α = 0.98; ICC (2,1) 0.98 (95% CI 0.97, 0.98). Linear weighted κ coefficients were mostly good (i.e. 0.61–0.77) for the activity items (Q1–21), although one (Q17) was marginally lower at 0.58. Coefficients for the symptom/self-image items (Q22–30) were generally lower and mostly moderate, ranging from 0.50 to 0.66. DASH concurrent validity was strong: HAQ20 rs = 0.91; SF36v2 Physical Function r = −0.84; SF36v2 bodily pain r = −0.71; hand pain rs = 0.75; pain rs = 0.70; fatigue rs = 0.64. The DASH discriminated between good, moderate and poor self-reported disease activity (P = 0.001). The MDC95 DASH score = 9.26. There were no floor and ceiling effects.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.013 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".