A New Wrist Clinical Evaluation Score

Herzberg, Guillaume; Burnier, Marion; Nakamura, Toshiyasu

doi:10.1055/s-0037-1607328

Cited by 9 publications

(2 citation statements)

References 12 publications

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“…Outcome measures included the QuickDASH 2 , PRWE 7 , and EuroQol-5 Dimensions-3 Levels (EQ-5D-3L) 15 . A Normal Wrist Score (NWS) was also calculated by asking the patients the question “Taking into consideration the look, feel, and function of your wrist, how normal do you think your wrist is?”, to which they responded by marking an “x” on a visual analogue scale numbered 0 to 100, with 100 meaning the most normal and 0 meaning the least normal 16,17 . The QuickDASH includes an 11-item disability and symptom section (with each item scored from 1 to 5) and 2 optional sports/performing arts and work modules 2 .…”

Section: Methodsmentioning

confidence: 99%

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QuickDASH and PRWE Are Not Optimal Patient-Reported Outcome Measures After Distal Radial Fracture Due to Ceiling Effect

Bell

Oliver

White

et al. 2023

Journal of Bone and Joint Surgery

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Background: The aim of this study was to determine the floor and ceiling effects for both the QuickDASH (shortened version of the Disabilities of the Arm, Shoulder and Hand [DASH] questionnaire) and the PRWE (Patient-Rated Wrist Evaluation) following a distal radial fracture (DRF). Secondary aims were to determine the degree to which patients with a floor or ceiling effect felt that their wrist was “normal” according to the Normal Wrist Score (NWS) and if there were patient factors associated with achieving a floor or ceiling effect. Methods: A retrospective cohort study of patients in whom a DRF was managed at the study center during a single year was undertaken. Outcome measures included the QuickDASH, PRWE, EuroQol-5 Dimensions-3 Levels (EQ-5D-3L), and NWS. Results: There were 526 patients with a mean age of 65 years (range, 20 to 95 years), and 421 (80%) were female. Most patients were managed nonsurgically (73%, n = 385). The mean follow-up was 4.8 years (range, 4.3 to 5.5 years). A ceiling effect was observed for both the QuickDASH (22.3% of patients with the best possible score) and the PRWE (28.5%). When defined as a score that differed from the best available score by less than the minimum clinically important difference (MCID) for the scoring system, the ceiling effect increased to 62.8% for the QuickDASH and 60% for the PRWE. Patients who had a ceiling score on the QuickDASH and the PWRE had a median NWS of 96 and 98, respectively, and those who had a score within 1 MCID of the ceiling score reported a median NWS of 91 and 92, respectively. On logistic regression analysis, a dominant-hand injury and better health-related quality of life were the factors associated with both QuickDASH and PRWE ceiling scores (all p < 0.05). Conclusions: The QuickDASH and PRWE demonstrate ceiling effects when used to assess the outcome of DRF management. Some patients achieving ceiling scores did not consider their wrist to be “normal.” Future research on patient-reported outcome assessment tools for DRFs should aim to limit the ceiling effect, especially for individuals or groups that are more likely to achieve a ceiling score. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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