Reliability by Surgical Status of Self-Reported Outcomes in Patients Who Have Shoulder Pathologies

Abstract

Study Design: A test-retest design was used to evaluate the reliability of the self-report sections of 4 shoulder pain and disability scales. Objective: The objective of the study was to compare interitem consistency and test-retest reliability by surgical status (postoperative versus nonoperative) and to evaluate the effect of surgical status in the prediction of retest scores. Background: Patients and healthcare providers evaluate shoulder status based on self-evaluations of pain and disability. Shoulder outcome measures have been developed that include self-reports, but the properties of these measures have not been assessed by surgical status. Methods and Measures: A questionnaire containing self-report sections of 4 shoulder scales was administered to study participants twice with 1 week between administrations. The outcome measures examined were the: (1) University of California at Los Angeles (UCLA) Shoulder Score; (2) Constant-Murley Scale (CMS); (3) American Shoulder and Elbow Society (ASES) Shoulder Index; and (4) Shoulder Pain and Disability Index (SPADI).Intraclass correlation coefficients (ICC) were calculated to estimate the test-retest reliability of each of the scales and subscales. The interitem consistencies of the multi-item subscales were assessed using Cronbach's alpha. The effect of surgical status on shoulder outcome scale reliability was evaluated using a general linear models approach. Results: The interitem consistency estimates for the multi-item scales were high with both operative and nonoperative participants (0.88 to 0.96). With the exception of the satisfaction subscale of the UCLA Shoulder Score for the nonsurgical group, the estimated intraclass coefficients ranged from 0.51 to 0.91. The prediction of UCLA-satisfaction and ASES-disability, pain, and total retest scores was improved with the addition of surgical status into a regression model. Conclusions:The examined scales exhibited good internal consistency across surgical status. The postsurgical sample's reproducibility estimates tended to be higher than those of the nonsurgical sample. Reliability of shoulder outcome scales can be affected by patient surgical status.

The Penn Shoulder Score: Reliability and Validity

“…Testretest reliability of the pain scale and error estimates of the CSS total score have been reported. 10,13 The patient can complete the self-report section of the CSS in approximately 5 minutes and the clinician can complete the range of motion and strength portion in approximately 10 minutes. This scale has been used internationally for reporting outcome of various shoulder conditions.…”

“…17 This scale contains 1 item that dichotomizes the patient's response into ''satisfied and better'' and ''not satisfied and worse.'' 13,17 Limiting patient responses to these 2 options allows for only a gross estimate of the patient's level of satisfaction. 13 Cook and colleagues 13 reported an ICC value of 0.79 for this item in patients post shoulder surgery.…”

“…13,17 Limiting patient responses to these 2 options allows for only a gross estimate of the patient's level of satisfaction. 13 Cook and colleagues 13 reported an ICC value of 0.79 for this item in patients post shoulder surgery. However, they were unable to calculate a valid reliability statistic for a group of patients without surgery, partly because 8 of 24 respondents changed their satisfaction rating between the 2 test administrations.…”

Reliability of Function-Related Tests in Patients with Shoulder Pathologies

“…14 Cook et al 3 investigated the reliability of 4 selfreports of shoulder function and suggested that the University of California at Los Angeles (UCLA) Shoulder Scale is inappropriate for use in individuals who did not have surgery because of low reliability. 3 Additionally, self-report measures may also be subject to perceptual differences because function is influenced by psychological, social, environmental, and physical factors. 6,19 Accordingly, a battery of function-related tests has the potential to complement functional outcome assessment in patients with various shoulder pathologies.…”

Shoulder hemiarthroplasty for the treatment of three and four part fractures of the proximal humerus using Comprehensive® Fracture stem

“…Functional status was assessed using University of California Los Angeles (UCLA) shoulder end result assessment [14], simple shoulder test (SST) [15] and American Shoulder and Elbow Society (ASES) shoulder index [16].…”