Evaluation of Oxford instability shoulder score, Western Ontario shoulder instability Index and Euroqol in patients with slap (superior labral anterior posterior) lesions or recurrent anterior dislocations of the shoulder

Abstract

BackgroundHaving an estimate of the measurement error of self-report questionnaires is important both for assessing follow-up results after treatment and when planning intervention studies. Specific questionnaires have been evaluated for patients with shoulder instability, but not in particular for patients with SLAP (superior labral anterior posterior) lesions or recurrent dislocations. The aim of this study was to evaluate the agreement, reliability, and validity of two commonly questionnaires developed for patients with shoulder instability and a generic questionnaire in patients with SLAP lesions or recurrent anterior shoulder dislocations.MethodsSeventy-one patients were included, 33 had recurrent anterior dislocations and 38 had a SLAP lesion. The patients filled in the questionnaires twice at the same time of the day (± 2 hours) with a one week interval between administrations. We tested the Oxford Instability Shoulder Score (OISS) (range 12 to 60), the Western Ontario Shoulder Instability Index (WOSI) (0 to 2100), and the EuroQol: EQ-5D (−0.5 to 1.0) and EQ-VAS (0 to 100). Hypotheses were defined to test validity.ResultsICC ranged from 0.89 (95% CI 0.83 to 0.93) to 0.92 (0.87 to 0.95) for OISS, WOSI, and EQ-VAS and was 0.66 (0.50 to 0.77) for EQ-5D. The limits of agreement for the scores were: -7.8 to 8.4 for OISS; -339.9 to 344.8 for WOSI; -0.4 to 0.4 for EQ-5D; and −17.2 and 16.2 for EQ-VAS. All questionnaires reflect the construct that was measured. The correlation between WOSI and OISS was 0.73 and ranged from 0.49 to 0.54 between the shoulder questionnaires and the generic questionnaires. The divergent validity was acceptable, convergent validity failed, and known group validity was acceptable only for OISS.ConclusionMeasurement errors and limitations in validity should be considered when change scores of OISS and WOSI are interpreted in patients with SLAP lesions or recurrent shoulder dislocations. EQ-5D is not recommended as a single outcome.

Generalised joint hypermobility and shoulder joint hypermobility, – risk of upper body musculoskeletal symptoms and reduced quality of life in the general population

“…Selection bias was anticipated not to have influenced the results in relation to musculoskeletal symptoms and HRQoL, since the 12-month prevalence of musculoskeletal symptoms and activity limitations for the participants were in accordance with previous studies [17–19, 22], as was the distribution of responses to the HRQoL [18, 39, 40, 47, 19]. With the relatively long recall periods for both GJH (5-PQ: ever/now) and musculoskeletal symptoms (SNQ: last 12 months) recall bias may be present, but this does not seem likely, since satisfactory psychometric properties (reliability and validity) have been reported for both 5-PQ and SNQ [3, 15, 30, 32].…”

“…Furthermore, with the exception of the additional question on GJHS, only validated questionnaires were used in the current population-based survey [3, 40, 48–50]. Since both unadjusted and adjusted models showed almost the same pattern of significance, the current findings and associations appear to be consistent.…”

Long-Term Results After SLAP Repair: A 5-Year Follow-up Study of 107 Patients With Comparison of Patients Aged Over and Under 40 Years

“…Assuming 10% dropout, we planned to include 40 patients in each group. In a later study by Skare et al,[93][94][95] we found the minimal clinically important change for Rowe to be 17. At 6 months, there were no cross-overs, and the results were analyzed and interpreted blindly, as recommended by Järvinen et al96 Continuous variables were presented as mean values with 95% CI and categorical values as numbers and percentages.…”

“…102 The outcome measures for the same group of patients were validated particularly for the present study. [93][94][95] Our group ran parallel studies validating the Rowe score, the Western Ontario Shoulder Index, and the Oxford Instability Shoulder Score. The ideal situation would have been to have the minimal clinical important difference (MCID) calculated before designing the study.…”

Generalised joint hypermobility and knee joint hypermobility: prevalence, knee joint symptoms and health‐related quality of life in a Danish adult population

“…In patients with shoulder instability problems, EQ‐5D‐5L has been found to have satisfactory psychometrics properties …”