Choosing patient-reported outcome measures for shoulder pathology

Roberto Padua, Laura de Girolamo, Alberto Grassi, Davide Cucchi, Roberto Padua, Laura de Girolamo, Alberto Grassi, Davide Cucchi

Abstract

This study was designed to identify the most frequent shoulder patient-reported outcome measures (PROMs) reported in high-quality literature.A systematic review was performed to identify shoulder PROMs, and their diffusion within the scientific literature was tested with a subsequent dedicated search in MEDLINE.506 studies were included in the final data analysis, for a total number of 36,553 patients.The Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), the American Shoulder, Elbow Surgeons Score (ASES) and the Shoulder Pain and Disability Index (SPADI) were the most frequently reported PROMs in the analysed publications, with disease-specific PROMs being used with increasing frequency.A core set of outcome measures for future studies on patients with shoulder pathologies, based on the international acceptance and diffusion of each PROM, is needed.A combination of the DASH score for shoulder outcome assessment with more specific PROMs, such as the ASES for rotator cuff pathology and osteoarthritis and the SPADI for shoulder stiffness and shoulder pain of unspecified origin, is proposed as a recommended set of PROMs. Cite this article: EFORT Open Rev 2021;6:779-787. DOI: 10.1302/2058-5241.6.200109.

Keywords: outcome measures; patient-reported; shoulder.

Conflict of interest statement

ICMJE Conflict of interest statement: The authors declare no conflict of interest relevant to this work.

© 2021 The author(s).

Figures

Fig. 1
Fig. 1
(A) Frequency distribution of the investigated patient-reported outcome measures (PROMs) among the studies considered. (B) Number of patients analysed with the selected PROMs throughout the studies considered. Since more than one PROM can be used in each study, the sum of all percentages is not necessarily 100%. Note. DASH, Disabilities of the Arm, Shoulder and Hand questionnaire; ASES, American Shoulder and Elbow Surgeons Score; SST, Simple Shoulder Test; SPADI, Shoulder Pain and Disability Index; OSS, Oxford Shoulder Score; WOSI, Western Ontario Shoulder Instability Index; WOOS, Western Ontario Osteoarthritis of the Shoulder; WORC, Western Ontario Rotator Cuff Index; SDQ, Shoulder Disability Questionnaire.
Fig. 2
Fig. 2
Frequency of the selected patient-reported outcome measures (PROMs) in the studies about rotator cuff and subacromial pathologies. Since more than one PROM can be used in each study, the sum of all percentages is not necessarily 100%. Note. DASH, Disabilities of the Arm, Shoulder and Hand questionnaire; ASES, American Shoulder and Elbow Surgeons Score; SST, Simple Shoulder Test; SPADI, Shoulder Pain and Disability Index; OSS, Oxford Shoulder Score; WOSI, Western Ontario Shoulder Instability Index; WOOS, Western Ontario Osteoarthritis of the Shoulder; WORC, Western Ontario Rotator Cuff Index; SDQ, Shoulder Disability Questionnaire.
Fig. 3
Fig. 3
Frequency of the selected patient-reported outcome measures (PROMs) in the studies about proximal humerus fractures. Since more than one PROM can be used in each study, the sum of all percentages is not necessarily 100%. Note. DASH, Disabilities of the Arm, Shoulder and Hand questionnaire; ASES, American Shoulder and Elbow Surgeons Score; SST, Simple Shoulder Test; SPADI, Shoulder Pain and Disability Index; OSS, Oxford Shoulder Score; WOSI, Western Ontario Shoulder Instability Index; WOOS, Western Ontario Osteoarthritis of the Shoulder; WORC, Western Ontario Rotator Cuff Index; SDQ, Shoulder Disability Questionnaire.
Fig. 4
Fig. 4
Frequency of the selected patient-reported outcome measures (PROMs) in the studies about rotator shoulder instability. Since more than one PROM can be used in each study, the sum of all percentages is not necessarily 100%. Note. DASH, Disabilities of the Arm, Shoulder and Hand questionnaire; ASES, American Shoulder and Elbow Surgeons Score; SST, Simple Shoulder Test; SPADI, Shoulder Pain and Disability Index; OSS, Oxford Shoulder Score; WOSI, Western Ontario Shoulder Instability Index; WOOS, Western Ontario Osteoarthritis of the Shoulder; WORC, Western Ontario Rotator Cuff Index; SDQ, Shoulder Disability Questionnaire.
Fig. 5
Fig. 5
Frequency of the selected patient-reported outcome measures (PROMs) in the studies about glenohumeral osteoarthritis. Since more than one PROM can be used in each study, the sum of all percentages is not necessarily 100%. Note. DASH, Disabilities of the Arm, Shoulder and Hand questionnaire; ASES, American Shoulder and Elbow Surgeons Score; SST, Simple Shoulder Test; SPADI, Shoulder Pain and Disability Index; OSS, Oxford Shoulder Score; WOSI, Western Ontario Shoulder Instability Index; WOOS, Western Ontario Osteoarthritis of the Shoulder; WORC, Western Ontario Rotator Cuff Index; SDQ, Shoulder Disability Questionnaire.
Fig. 6
Fig. 6
Frequency of the selected patient-reported outcome measures (PROMs) in the studies about shoulder stiffness. Since more than one PROM can be used in each study, the sum of all percentages is not necessarily 100%. Note. DASH, Disabilities of the Arm, Shoulder and Hand questionnaire; ASES, American Shoulder and Elbow Surgeons Score; SST, Simple Shoulder Test; SPADI, Shoulder Pain and Disability Index; OSS, Oxford Shoulder Score; WOSI, Western Ontario Shoulder Instability Index; WOOS, Western Ontario Osteoarthritis of the Shoulder; WORC, Western Ontario Rotator Cuff Index; SDQ, Shoulder Disability Questionnaire.
Fig. 7
Fig. 7
Frequency of the selected patient-reported outcome measures (PROMs) in the studies about calcific tendinitis of the rotator cuff. Since more than one PROM can be used in each study, the sum of all percentages is not necessarily 100%. Note. DASH, Disabilities of the Arm, Shoulder and Hand questionnaire; ASES, American Shoulder and Elbow Surgeons Score; SST, Simple Shoulder Test; SPADI, Shoulder Pain and Disability Index; OSS, Oxford Shoulder Score; WOSI, Western Ontario Shoulder Instability Index; WOOS, Western Ontario Osteoarthritis of the Shoulder; WORC, Western Ontario Rotator Cuff Index; SDQ, Shoulder Disability Questionnaire.
Fig. 8
Fig. 8
Frequency of the selected patient-reported outcome measures (PROMs) in the studies about shoulder pain of unspecified origin. Since more than one PROM can be used in each study, the sum of all percentages is not necessarily 100%. Note. DASH, Disabilities of the Arm, Shoulder and Hand questionnaire; ASES, American Shoulder and Elbow Surgeons Score; SST, Simple Shoulder Test; SPADI, Shoulder Pain and Disability Index; OSS, Oxford Shoulder Score; WOSI, Western Ontario Shoulder Instability Index; WOOS, Western Ontario Osteoarthritis of the Shoulder; WORC, Western Ontario Rotator Cuff Index; SDQ, Shoulder Disability Questionnaire.
Fig. 9
Fig. 9
Percentage of patient-reported outcome measure diffusion within each pathology category. Note. DASH, Disabilities of the Arm, Shoulder and Hand questionnaire; ASES, American Shoulder and Elbow Surgeons Score; SST, Simple Shoulder Test; SPADI, Shoulder Pain and Disability Index; OSS, Oxford Shoulder Score; WOSI, Western Ontario Shoulder Instability Index; WOOS, Western Ontario Osteoarthritis of the Shoulder.

References

    1. Mosher ZA, Ewing MA, Collins CS, et al. . Usage trends of patient-reported outcome measures in shoulder literature. J Am Acad Orthop Surg 2019;October:1.
    1. Amadio PC. Outcomes measurements. J Bone Joint Surg [Am] 1993;75-A:1583–1584.
    1. Dawson J, Carr A. Outcomes evaluation in orthopaedics. J Bone Joint Surg [Br] 2001;83-B:313–315.
    1. Pynsent PB. Choosing an outcome measure. J Bone Joint Surg [Br] 2001;83-B:792–794.
    1. Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 1993;46:1417–1432.
    1. Turchin DC, Beaton DE, Richards RR. Validity of observer-based aggregate scoring systems as descriptors of elbow pain, function, and disability. J Bone Joint Surg [Am] 1998;80-A:154–162.
    1. Angst F, Schwyzer H-K, Aeschlimann A, Simmen BR, Goldhahn J. 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). Arthritis Care Res (Hoboken) 2011;63:S174–S188.
    1. Marx RG, Wilson SM, Swiontkowski MF. Updating the assignment of levels of evidence. J Bone Joint Surg [Am] 2015;97-A:1–2.
    1. Richards RR, An K-N, Bigliani LU, et al. . A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg 1994;3:347–352.
    1. Tibone J, Bradley J. Evaluation of treatment outcomes for the athlete’s shoulder. In: Matsen FA III, Fu FH, Hawkins RJ, eds. The shoulder: a balance of mobility and stability. Rosemont, IL: American Academy of Orthopaedic Surgeons, 1993:519–529.
    1. Hudak PL, Amadio PC, Bombardier C, et al. ; The Upper Extremity Collaborative Group (UECG). Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. Am J Ind Med 1996;29:602–608.
    1. Alberta FG, ElAttrache NS, Bissell S, et al. . The development and validation of a functional assessment tool for the upper extremity in the overhead athlete. Am J Sports Med 2010;38:903–911.
    1. L’Insalata JC, Warren RF, Cohen SB, Altchek DW, Peterson MG. A self-administered questionnaire for assessment of symptoms and function of the shoulder. J Bone Joint Surg [Am] 1997;79-A:738–748.
    1. Watson L, Story I, Dalziel R, Hoy G, Shimmin A, Woods D. A new clinical outcome measure of glenohumeral joint instability: the MISS questionnaire. J Shoulder Elbow Surg 2005;14:22–30.
    1. Dawson J, Fitzpatrick R, Carr A. The assessment of shoulder instability: the development and validation of a questionnaire. J Bone Joint Surg [Br] 1999;81-B:420–426.
    1. Dawson J, Fitzpatrick R, Carr A. Questionnaire on the perceptions of patients about shoulder surgery. J Bone Joint Surg [Br] 1996;78-B:593–600.
    1. Leggin BG, Michener LA, Shaffer MA, Brenneman SK, Iannotti JP, Williams GR, Jr. The Penn shoulder score: reliability and validity. J Orthop Sports Phys Ther 2006;36:138–151.
    1. Hollinshead RM, Mohtadi NG, Vande Guchte RA, Wadey VM. Two 6-year follow-up studies of large and massive rotator cuff tears: comparison of outcome measures. J Shoulder Elbow Surg 2000;9:373–381.
    1. Rowe CR, Patel D, Southmayd WW. The Bankart procedure: a long-term end-result study. J Bone Joint Surg [Am] 1978-A;60:1–16.
    1. van der Windt DAWM, van der Heijden GJMG, de Winter AF, Koes BW, Devillé W, Bouter LM. The responsiveness of the Shoulder Disability Questionnaire. Ann Rheum Dis 1998;57:82–87.
    1. Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res 1991;4:143–149.
    1. Lippitt S, Harryman D, Matsen F, III. A practical tool for evaluation function: the simple shoulder test. In: Matsen FA III, Fu FH, Hawkins RJ, eds. The shoulder: a balance of mobility and stability. Rosemont, IL: American Academy of Orthopaedic Surgeons, 1993:501–518.
    1. Gabel CP, Michener LA, Burkett B, Neller A. The upper limb functional index: development and determination of reliability, validity, and responsiveness. J Hand Ther 2006;19:328–348.
    1. Walch G. The Walch-Duplay score for instability of the shoulder. Abstracts of the First Open Congress of the European Society of Surgery of the Shoulder and Elbow. Paris:European Society of Surgery of the Shoulder and Elbow (SECEC), 1987:51–55.
    1. Lo IKY, Griffin S, Kirkley A. The development of a disease-specific quality of life measurement tool for osteoarthritis of the shoulder: The Western Ontario Osteoarthritis of the Shoulder (WOOS) index. Osteoarthritis Cartilage 2001;9:771–778.
    1. Kirkley A, Alvarez C, Griffin S. The development and evaluation of a disease-specific quality-of-life questionnaire for disorders of the rotator cuff: The Western Ontario Rotator Cuff Index. Clin J Sport Med 2003;13:84–92.
    1. Kirkley A, Griffin S, McLintock H, Ng L. The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability: The Western Ontario Shoulder Instability Index (WOSI). Am J Sports Med 1998;26:764–772.
    1. Epstein AM. The outcomes movement—will it get us where we want to go? N Engl J Med 1990;323:266–270.
    1. Keller RB. Outcomes research in orthopaedics. J Am Acad Orthop Surg 1993;1:122–129.
    1. Bradham DD. Outcomes research in orthopedics: history, perspectives, concepts, and future. Arthroscopy 1994;10:493–501.
    1. Williamson PR, Gamble C, Altman DG, Hutton JL. Outcome selection bias in meta-analysis. Stat Methods Med Res 2005;14:515–524.
    1. Offenbächer M, Ewert T, Sangha O, Stucki G. Validation of a German version of the ‘Disabilities of Arm, Shoulder and Hand’ questionnaire (DASH-G). Z Rheumatol 2003;62:168–177.
    1. Padua R, Padua L, Ceccarelli E, et al. . Italian version of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire: cross-cultural adaptation and validation. J Hand Surg [Br] 2003;28:179–186.
    1. Rosales RS, Delgado EB, Díez de la Lastra-Bosch I. Evaluation of the Spanish version of the DASH and carpal tunnel syndrome health-related quality-of-life instruments: cross-cultural adaptation process and reliability. J Hand Surg Am 2002;27:334–343.
    1. Atroshi I, Gummesson C, Andersson B, Dahlgren E, Johansson A. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: reliability and validity of the Swedish version evaluated in 176 patients. Acta Orthop Scand 2000;71:613–618.
    1. Dubert T, Voche P, Dumontier C, Dinh A. The DASH questionnaire: French translation of a trans-cultural adaptation. Chir Main 2001;20:294–302.
    1. Veehof MM, Sleegers EJA, van Veldhoven NHMJ, Schuurman AH, van Meeteren NLU. Psychometric qualities of the Dutch language version of the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH-DLV). J Hand Ther 2002;15:347–354.
    1. Chan RKY, Leung YC, Leung FKL, et al. . Reliability and validity of the Chinese (Queen Mary Hospital, Hong Kong version) of the Disabilities of the Arm, Shoulder and Hand on patients with upper extremity musculoskeletal disorders in Hong Kong. Hong Kong J Occup Ther 2019;32:62–68.
    1. Kc S, Sharma S, Ginn K, Almadi T, Subedi H, Reed D. Cross-cultural adaptation and measurement properties of the Nepali version of the DASH (Disability of Arm, Shoulder and Hand) in patients with shoulder pain. Health Qual Life Outcomes 2019;17:51.
    1. Buntragulpoontawee M, Phutrit S, Tongprasert S, Wongpakaran T, Khunachiva J. Construct validity, test-retest reliability and internal consistency of the Thai version of the disabilities of the arm, shoulder and hand questionnaire (DASH-TH) in patients with carpal tunnel syndrome. BMC Res Notes 2018;11:208.
    1. Chen H, Ji X, Zhang W, Zhang Y, Zhang L, Tang P. Validation of the simplified Chinese (Mainland) version of the Disability of the Arm, Shoulder, and Hand questionnaire (DASH-CHNPLAGH). J Orthop Surg Res 2015;10:76.
    1. Hong SW, Gong HS, Park JW, Roh YH, Baek GH. Validity, reliability and responsiveness of the Korean version of Quick Disabilities of the Arm, Shoulder, and Hand questionnaire in patients with carpal tunnel syndrome. J Korean Med Sci 2018;33:e249.
    1. Haldorsen B, Svege I, Roe Y, Bergland A. Reliability and validity of the Norwegian version of the Disabilities of the Arm, Shoulder and Hand questionnaire in patients with shoulder impingement syndrome. BMC Musculoskelet Disord 2014;15:78.
    1. Imaeda T, Toh S, Nakao Y, et al. ; Impairment Evaluation Committee, Japanese Society for Surgery of the Hand. Validation of the Japanese Society for Surgery of the Hand version of the Disability of the Arm, Shoulder, and Hand questionnaire. J Orthop Sci 2005;10:353–359.
    1. Mulero-Portela AL, Colón-Santaella CL, Cruz-Gómez C. Cross-cultural adaptation of the Disability of Arm, Shoulder, and Hand questionnaire: Spanish for Puerto Rico version. Int J Rehabil Res 2009;32:287–293.
    1. DASH: available translations. .
    1. Wylie JD, Beckmann JT, Granger E, Tashjian RZ. Functional outcomes assessment in shoulder surgery. World J Orthop 2014;5:623–633.
    1. Kirkley A, Griffin S, Dainty K. Scoring systems for the functional assessment of the shoulder. Arthroscopy 2003;19:1109–1120.
    1. Breckenridge JD, McAuley JH. Shoulder Pain and Disability Index (SPADI). J Physiother 2011;57:197.
    1. Salomonsson B, Ahlström S, Dalén N, Lillkrona U. The Western Ontario Shoulder Instability Index (WOSI): validity, reliability, and responsiveness retested with a Swedish translation. Acta Orthop 2009;80:233–238.
    1. van der Linde JA, Willems WJ, van Kampen DA, van Beers LWAH, van Deurzen DFP, Terwee CB. Measurement properties of the Western Ontario Shoulder Instability index in Dutch patients with shoulder instability. BMC Musculoskelet Disord 2014;15:211.
    1. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 1987;214:160–164.
    1. Chelli M, Levy Y, Lavoué V, Clowez G, Gonzalez J-F, Boileau P. The ‘Auto-Constant’: can we estimate the Constant-Murley score with a self-administered questionnaire? A pilot study. Orthop Traumatol Surg Res 2019;105:251–256.

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi