Can the QuickDASH PROM be Altered by First Completing the Tasks on the Instrument?

Area of Science:

• Orthopaedic Surgery
• Health Services Research
• Patient-Reported Outcome Measures

Background:

• Health systems utilize patient-reported outcome measures (PROMs) for quality improvement and value-based payments.
• Psychosocial factors and priming are known to influence PROM scores.
• The impact of completing functional tasks before PROM completion requires further evaluation.

Purpose of the Study:

• To determine if QuickDASH scores change after patients complete functional tasks compared to baseline.
• To compare the change in QuickDASH scores between an intervention (task completion) group and a control group.
• To assess if a greater proportion of patients in the intervention group achieve a minimally clinically important difference (MCID) of 14 points.

Main Methods:

• 132 patients with hand or upper-extremity problems completed the QuickDASH PROM.
• Intervention group: completed functional tasks on the QuickDASH before a follow-up PROM.
• Control group: completed QuickDASH at baseline and follow-up 5 minutes later; statistical analyses included paired/unpaired t-tests and Fisher's exact test.

Main Results:

• The intervention group showed a significant decrease in QuickDASH scores (-14 points, p < 0.001) after task completion.
• The change in QuickDASH scores was significantly greater in the intervention group compared to the control group (p < 0.001).
• A higher proportion of the intervention group (38%) achieved an MCID of 14 points compared to the control group (10%, p = 0.019).

Conclusions:

• Completing QuickDASH functional tasks prior to questionnaire completion can reduce reported disability and improve PROM scores.
• Modifiable factors influencing PROM scores, like task completion context, need analysis before PROM implementation in reimbursement models.
• Standardizing PROM administration is recommended to limit contextual influences and ensure validity in value-based payment models.