Clinical rating systems in elbow research—a systematic review exploring trends and distributions of use

Evans, Jonathan P; Smith, Chris; Fine, Nicola; Porter, Ian; Gangannagaripalli, Jaheeda; Goodwin, Victoria A; Valderas, José M

doi:10.1016/j.jse.2017.12.027

Cited by 42 publications

(38 citation statements)

References 52 publications

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“…Overall, our data revealed a clinically important benefit of needle tenotomy in terms of DASH and VAS‐P changes over time. Although DASH is not an elbow‐specific rating score, it is the first or second choice for elbow tendinopathy . Of note, it is the only score that has been assessed for cross‐cultural validity in Spanish .…”

Section: Discussionmentioning

confidence: 99%

“…Although DASH is not an elbow-specific rating score, it is the first or second choice for elbow tendinopathy. 22 Of note, it is the only score that has been assessed for cross-cultural validity in Spanish. 23 Threshold changes of 10 (5-15) points for the DASH are considered to represent an improvement important to patients, the so-called minimal clinically important difference (MCDI).…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Outcome Following Tenotomy in Patients with Recalcitrant Epicondylopathy

Martín

Atilano

Merino

et al. 2019

PM&R

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Background Elbow tendinopathies are associated with tenderness, pain, and functional disability with ensuing socioeconomic costs. There is lack of consensus regarding the best treatment for patients recalcitrant to first‐line conservative treatments. Percutaneous needle tenotomy is considered a regenerative approach that injures the tendon to elicit a healing response. Objective To investigate whether demographic characteristics, clinical factors, baseline sonographic entities, or their interactions are related to the likelihood of responding positively to needle tenotomy over a 1‐year follow‐up period. Design Prospective case series. Setting Tertiary institutional hospital. Participants Patients with elbow tendinopathy for whom conservative treatments had failed and who had persistent symptoms lasting for at least 3 months. Methods Patients underwent needle tenotomy with or without PRP followed by a lighter needle tenotomy within a 2‐week interval as part of treatment. Main Outcome Measurements Disabilities of the Arm, Shoulder and Hand (DASH) and Visual Analogue Scale for pain (VAS‐P) scores were assessed before intervention (baseline) and at 6 weeks and 3, 6, and 12 months after intervention. A generalized linear mixed effects model was created to examine whether injectate type, clinical, demographic, or pretreatment sonographic entities or their interactions influenced clinical outcomes. Results The authors analyzed 74 elbows (71 patients). At baseline, analyzed patients (mean age: 49.48 years; 51.35% women) scored 43.30 and 5.83 on the DASH and VAS‐P, respectively. Pretreatment tendon vascularization was a predictor of pain (P = .011) and DASH score changes (P = .019). The linear mixed effect model revealed that male gender and hypercholesterolemia were associated with enhanced functional recovery, (P = .020 and P < .001, respectively). Moreover, the interactions between pretreatment vascular status (P = .039), echotexture (P = .037) and enthesophytes (P = .028) influenced the temporal pattern of functional recovery after needle tenotomy. Conclusions Baseline patient characteristics, such as gender and hypercholesterolemia, along with ultrasound features may be predictive of outcomes following needle tenotomy for elbow tendinopathy. Level of Evidence IV (NCT01945528).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predictors of Outcome Following Tenotomy in Patients with Recalcitrant Epicondylopathy

Martín

Atilano

Merino

et al. 2019

PM&R

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“…Similar studies have been conducted recently for both knee and elbow scoring systems, and they yielded important relationships about performance versus established quality standards and cross-cultural validation. 8,9 With the drive toward a value-based health care system and the proliferation of scoring systems, standardization of outcome measurements in surgery is of paramount importance. Schmidt et al 10 performed a systematic review evaluating validity, reliability and responsiveness of 11 PROMs that are applicable to a wide spectrum of shoulder disorders; their intent was to provide recommendations to clinicians and researchers about which PROMs to use.…”

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confidence: 99%

What Are We Measuring? A Systematic Review of Outcome Measurements Used in Shoulder Surgery

Ashton

Savage-Elliott

Granruth

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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The purpose of this study was to identify the most commonly used outcome measurements following shoulder surgery and to investigate demographic variables related to their use. Methods: PubMed and Embase were searched to identify studies in which at least 1 shoulder-specific outcome measurement was used. Exclusion criteria included duplicate studies, review articles, lack of surgical arm, written in a language other than English, or not adult-specific. Additionally, surgeries were subcategorized based on the type of pathology leading to surgery. Results: Of the 589 articles identified in the search, 180 met the inclusion criteria. A total of 35 shoulder-specific outcome measurements were reported. The Constant-Murley score (CMS), American Shoulder and Elbow Surgeons Shoulder Score (ASES), Subjective Shoulder Value (SSV), Simple Shoulder Test (SST), and University of California Los Angeles Score (UCLA) were used in more than 10% of the articles. The CMS and SSV were used more commonly together than individually (P ¼ .0074). Additionally, the ASES (P < .00001) and CMS (P ¼ .0109) were associated with the country of origin of the article. The SST was used more frequently in randomized control trials (P ¼ .0287). The ASES and DASH were associated with surgeries categorized under the degenerative indication (P ¼ .001 and P ¼ .0146). Finally, the SSV, ASES and DASH were all found to be significantly paired with surgeries that indicated traumatic pathology (P ¼ .0061, P ¼ .0077 and P ¼ .0069, respectively). Conclusions: There is great variability among the outcome measurements currently being used for assessing function following orthopaedic shoulder surgery; however, 5 scoring systems are used more frequently than others. There remains a large discrepancy between the ideal reporting, as noted in the recent literature review, and the current state of outcomes reported at this time. Clinical Relevance: By identifying and evaluating the heterogeneity of the reporting and the usage of the performance indicators, these results can guide the standardization of outcome measurements in shoulder surgery and allow for better comparability when assessing outcomes between patients and studies.

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“…The best-known questionnaire is the Disability of Arm, Shoulder and Hand (DASH) questionnaire [16] or its short form, the quickDASH [17]. The DASH is the most commonly used questionnaire in studies on tendinopathies of the elbow, followed by PRTEE and the Mayo Elbow Performance Score (MEPS) [18,19]. The DASH demonstrates good scores for reliability, validity and responsiveness in patients with tennis elbow [20].…”

Section: Discussionmentioning

confidence: 99%

Patient-Rated Tennis Elbow Evaluation (PRTEE)

et al. 2020

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Background The Patient-Rated Tennis Elbow Evaluation questionnaire (PRTEE) is a specific questionnaire available for assessing the health status of patients with lateral epicondylitis. An official German translation does not yet exist. Objectives The aim of this study was to translate and cross-culturally adapt the English version of the PRTEE into German. Material and Methods The translation and cross-cultural adaptation was completed by an expert committee comprising people of varying professional and linguistic backgrounds. According to international guidelines, the English original was first translated into German, then back-translated and the final version was pre-tested on patients. Results No major difficulties were encountered during the translation process and smaller linguistic discrepancies could be resolved in the expert committee. For the pre-validation testing, 11 patients with extensor repair due to persistent lateral epicondylitis were included. They rated the questionnaire as easy to understand and complete. The final version was approved by the developers of the original questionnaire as the official German translation. Conclusions Although the measurement properties of the German version were not evaluated in this study, the original shows good reliability, validity and responsiveness. In summary, the PRTEE is a questionnaire quick and easy to complete for patients with lateral epicondylitis. Therefore, it is suitable for the clinical routine assessment of subjective health status or the outcome after an intervention.

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Clinical rating systems in elbow research—a systematic review exploring trends and distributions of use

Cited by 42 publications

References 52 publications

Predictors of Outcome Following Tenotomy in Patients with Recalcitrant Epicondylopathy

Predictors of Outcome Following Tenotomy in Patients with Recalcitrant Epicondylopathy

What Are We Measuring? A Systematic Review of Outcome Measurements Used in Shoulder Surgery

Patient-Rated Tennis Elbow Evaluation (PRTEE)

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