How Can We Improve Outcomes Assessment?

Chalmers, Peter N.; Verma, Nikhil N.

doi:10.3928/01477447-20151002-02

Cited by 1 publication

(1 citation statement)

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“…Being reliable instruments that measure progress by obtaining the perspective of patients, outcome measures are common in the field of orthopedic surgery. [1][2][3][4] The Disability of the Arm, Shoulder and Hand (DASH), American Shoulder and Elbow Surgeons Standard Shoulder Assessment score (ASES), and the Constant score outcome measures are widely used in the area of shoulder joint orthopedics. 5) Since the highest possible score may not be attainable even by patients with asymptomatic shoulders, comparing patient outcome measure scores to the highest score possible is not the most reliable evaluation method.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Health Perception on Shoulder Outcome Measure Scores

Hardy¹,

Sungur²,

Butler³

et al. 2019

Clin Shoulder Elbow

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Background: Patient reported outcome measures assess clinical progress from the patient’s perspective. This study explored the relationship between shoulder outcome measures (The Disability of the Arm, Shoulder and Hand [DASH], American Shoulder and Elbow Surgeons Standard Shoulder Assessment score [ASES], and Constant score) by comparing the best possible scores obtained in an asymptomatic population compared to overall perception of health, as measured by the SF-36 outcome measure.Methods: Volunteers (age range, 20?69 years) with asymptomatic shoulders and no history of shoulder pain, injury, surgery, imaging, or pathology (bilaterally) were included. The DASH and ASES measures were completed by 111 volunteers (72 female, 39 male), of which 92 completed the Constant score (56 female, 36 male). The SF-36 was completed by all volunteers (level of evidence: IV case series).Results: The mean (x) score for ASES measure on the right shoulder was higher for the left-hand dominant side (x=100.00 vs. 95.02, <i>p</i>-value<0.001); no other significant differences. Better SF-36 scores were associated with better DASH scores. Our prediction models suggest that perception of overall health affects the DASH scores. Sex affected all three shoulder measures scores.Conclusions: Comparing scores of shoulder outcome measures to the highest possible score is not the most informative way to interpret patient progress. Variables such as health status, sex, and hand dominance need to be considered. Furthermore, it is possible to use these variables to predict scores of outcome measures, which facilitates the healthcare provider to deliver individualized care to their patients.

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