Objective: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, along with its shortened version QuickDASH, are widely used self-assessment tools for evaluating upper limb function across various acute and chronic conditions. These tools aim to standardize outcome measures globally, contingent upon certified versions and adherence to calculation guidelines. While overall reliability of the QuickDASH is established, question-by-question reproducibility and methodology have not been rigorously assessed. Carpal tunnel syndrome was chosen for testing the reliability of the QuickDASH. This study aimed to evaluate the question-by-question reliability of the QuickDASH in carpal tunnel syndrome patients. Additionally, we surveyed members of the French Society of Hand Surgery regarding their QuickDASH usage practices and examined patients' functional expectations to correlate them with the questionnaire items. Our hypothesis suggested that response reliability might be affected by patient and practitioner factors or data collection methods.

Materials and methods: A non-interventional, single-center study was conducted from July 2023 to June 2024, including patients whose carpal tunnel syndrome was confirmed by clinical and electrophysiological tests. Patients completed the QuickDASH three times on consecutive days. Demographic, clinical, and paraclinical data were collected, including pain medication, ease of completion, age, sex, body mass index, profession, occupational health status, smoking, diabetes, thoracic outlet syndrome, and electroneuromyogram data. In October 2023, an online survey queried SFCM members on their QuickDASH application methods, response management, and knowledge of guidelines. Finally, A separate group of patients was interviewed preoperatively to describe their symptoms openly and symptoms were then compiled for analysis.

Results: The QuickDASH was found easy to complete by 93.3% of patients. The intraclass correlation scores indicated strong reliability for the overall QuickDASH, with 93% pre-operatively, 87% post-operatively and 92% in the overall population. However, question-specific intra-class correlations revealed less consistency, particularly for certain items post-operatively. Among surveyed practitioners, 65.5% reported that patients completed the QuickDASH autonomously, and 63.2% provided direct clarification when needed. While 58.1% of practitioners indicated the QuickDASH did not affect therapeutic decisions, 41.9% acknowledged its potential impact. Word clouds created from open-ended patient responses highlighted pain, tingling, and nocturnal symptoms as primary concerns pre-operatively.

Conclusion: The QuickDASH questionnaire demonstrated high reliability for measuring upper limb function in carpal tunnel syndrome patients, though some questions showed variability in their responses. Despite its widespread use, the implementation of the QuickDASH in clinical practice shows room for improvement, particularly regarding practitioner understanding and handling of missing data. The increased use of Patient-Reported Outcomes Measures should encourage us to develop more specific tools that are closer to patients' symptoms and functional requirements.

Keywords: PROMs; QuickDASH; carpal tunnel syndrome; hand; intra-class correlation index; questionnaire; self-evaluation; upper limb.

Copyright © 2025. Published by Elsevier Masson SAS.

目标：《手、肩和腕功能障碍问卷》（DASH）及其简化的版本QuickDASH是广泛用于评估各种急性和慢性状况下上肢功能的自我评价工具。这些工具旨在通过认证版本及遵循计算指南来标准化全球的结果测量。虽然总体来说QuickDASH的可靠性已经得到确立，但问题对问题之间的再现性及方法论尚未经过严格的评估。本研究选择了腕管综合征来进行QuickDASH可靠性的测试。该研究旨在评估腕管综合症患者使用QuickDASH时的问题特定再现性。此外，我们还调查了法国手外科协会成员关于他们使用QuickDASH的实践，并分析患者的预期功能与问卷项目的关联情况。我们的假设是，回答的可靠性可能会受到患者和从业者因素或数据收集方法的影响。

材料与方法：本研究是一项非干预性的单中心研究，于2023年7月至2024年6月期间进行，包括通过临床及电生理学测试确诊为腕管综合症的患者。患者在连续三天内完成了三次QuickDASH问卷。收集了人口统计、临床和辅助检查数据，包括止痛药物使用情况、完成问卷的难易程度、年龄、性别、体重指数、职业、就业健康状况、吸烟史、糖尿病病史、胸廓出口综合症以及电神经肌图（electroneuromyogram）的数据。2023年10月，一项在线调查向SFCM成员查询了他们使用QuickDASH的方法、应对问卷的回答方式及对指南的了解情况。最后，一个独立的患者组在术前接受开放性访谈以描述他们的症状，并将这些症状汇总进行分析。

结果：93.3%的患者认为QuickDASH易于完成。Intraclass correlation（ICC）分数显示整体上QuickDASH具有很强的可靠性，术前为93%，术后为87%，在总体人群中为92%。然而，特定问题的ICCs显示出一致性较低的情况，特别是在一些术后项目中。在接受调查的从业者中，65.5%报告患者自主完成QuickDASH，而63.2%表示当需要时会直接提供澄清说明。虽然58.1%的从业者表示QuickDASH不影响治疗决定，但41.9%的人承认它可能有影响。从开放性回答生成的词云显示疼痛、麻木和夜间症状在术前是主要关注点。

结论：尽管一些问题的回答显示出一定的变化性，QuickDASH问卷仍表现出测量腕管综合症患者上肢功能的高度可靠性。尽管广泛使用，但在临床实践中的实施仍有改进空间，特别是在从业者理解和处理缺失数据方面。增加使用患者报告结果量表（Patient-Reported Outcomes Measures）应促使我们开发更符合患者症状和功能性需求的特定工具。

关键词：PROMs；QuickDASH；腕管综合症；手部；组内相关性指数；问卷；自我评价；上肢。