Angst, Arthritis Care Res (Hoboken) 2011 - Measures of Adult Shoulder Function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and Its Short Version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society Standardized Shoulder Assessment Form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI) - Article Summary

Measures of Adult Shoulder Function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and Its Short Version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society Standardized Shoulder Assessment Form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI)

Angst, Goldhahn, et al.·Arthritis Care Res (Hoboken)·2011·586 citations·Review article

Angst (2011) systematically reviews nine validated shoulder outcome instruments — DASH, QuickDASH, SPADI, ASES, Constant Score, SST, OSS, SDQ, and WOSI. Each tool is evaluated for reliability, validity, responsiveness, and clinical usability to guide instrument selection in both practice and research. The review concludes with a recommended battery for clinical and research settings.

Key Findings

The SPADI is the most responsive shoulder-specific instrument, with an effect size of 2.10 and SRM of 1.72 for total shoulder arthroplasty — higher than any other tool reviewed. It is short (2-3 minutes), free, and recommended for every shoulder outcome battery.
DASH MCID is 10.2 points; QuickDASH MCID is 8.0 points (scale 0-100, where 100 = worst). The QuickDASH is a faster screen but systematically underestimates symptom severity and overestimates function compared to the full 30-item DASH. Important when choosing between them for research.
The Constant Score has no published MCID or MDC, and intertester reliability for strength measurement is low due to non-standardized testing protocols. It remains widely used in Europe but should not be used as a standalone metric for individual-level comparisons.
The WOSI is the best psychometrically tested instability-specific tool (ICC 0.87-0.98, Cronbach's alpha 0.88-0.96), but also lacks published MCID and MDC data. Add it to any battery when instability is the primary diagnosis.
The SDQ is explicitly not recommended by the authors due to absent or weak psychometric properties, low construct validity vs. other instruments, and no published MDC or MCID. Avoid it in both clinical and research settings.
Recommended clinical battery: QuickDASH + SPADI (or patient ASES) + Constant Score; add WOSI if instability is present. For research: full DASH + SPADI +/- clinical ASES or Constant Score.
When an instrument's MDC95% exceeds its MCID, the MDC95% should be used as the effective threshold for clinically meaningful change. A practical rule that applies to SPADI, DASH, and others in this review.

Board PearlSPADI is the most responsive shoulder instrument (ES 2.10); use QuickDASH + SPADI + Constant Score clinically, add WOSI for instability.

Reference

Measures of Adult Shoulder Function: Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and Its Short Version (QuickDASH), Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Society Standardized Shoulder Assessment Form, Constant (Murley) Score (CS), Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), and Western Ontario Shoulder Instability Index (WOSI).

Angst, Goldhahn, et al.Arthritis Care Res (Hoboken)2011586 citationsReview article