Concurrent evaluation of outcome measures is necessary to determine the most suitable measure(s) for a particular population. This property was evaluated in patients with rheumatic diseases undergoing shoulder surgery.
Methods
Three patient-reported measures (the Disabilities of the Arm, Shoulder and Hand Score; the Oxford Score; and the Shoulder Pain and Disability Index); three measures combining patient-reported and clinical outcomes (the Bostrom Shoulder Impairment Scale; the Constant Shoulder Score; and the Shoulder Function Assessment Scale); and one clinical measure (Range of Motion) were included. Responsiveness was expressed by the Standardized Response Mean (SRM).
Results
The study included 123 patients: 54 patients with shoulder arthroplasty (mean age 65.3 years) and 69 patients with non-arthroplasty (mean age 58.9 years). At 1 year, the Shoulder Function Assessment Scale was the most responsive measure in the arthroplasty group with SRM = 2.03 [95% confidence interval (CI) = 1.38 to 2.66] and Range of Motion (passive flexion) the least responsive measure with SRM = 0.54 (95% CI = 0.14 to 0.92). In the non-arthroplasty group, the Constant was the most responsive measure with SRM = 1.35 (95% CI = 0.87 to 1.83) and Range of Motion (passive flexion) the least responsive measure with SRM = 0.53 (95% CI = 0.16 to 0.90).
Conclusion
Measures comprising patient-reported outcomes were more responsive than clinical measures, and should be included when evaluating shoulder surgery in patients with rheumatic diseases.
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