Introduction/Rationale: Patient-reported outcome measures (PROMs), such as the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, assess unobservable health factors. To maintain validity across cultures, PROMs require translation, cross-cultural adaptation, and psychometric validation. This review evaluates the structural and cross-cultural validity of the DASH questionnaire after its adaptation in various linguistic and cultural contexts.
Objectives: This scoping review aimed to explore methodologies for evaluating the structural and cross-cultural validity of the translated DASH questionnaire across multiple languages.
Methods/Approach: Following the PRISMA Extension for scoping reviews checklist, a systematic search identified 50 studies on the validity of the translated DASH questionnaire. The review focused on methods such as exploratory and confirmatory factor analysis (EFA, CFA), Rasch analysis, and measurement invariance (MI) based on COSMIN guidelines.
Results/Practice Implications: Significant variability in methodologies was found. Structural validity was assessed using EFA in 16 studies and CFA in three. Cross-cultural validity was insufficiently addressed, with no studies using multiple-group confirmatory factor analysis (MGCFA) to assess MI. This emphasizes the need for robust methods in evaluating translated PROMs to ensure consistency across cultures.
Conclusion/Significance: The review highlights the importance of standardized methodologies for assessing the validity of translated PROMs and stresses applying COSMIN guidelines, particularly CFA for structural validity and MGCFA for cross-cultural validity. These findings support the use of valid, culturally responsive measures in global occupational therapy practices.