- •There is moderate to high evidence of bias present within the current evident of shoulder specific patient reported outcomes. Many gaps remain surrounding certain measurement properties, such as the property of validity (ie, is the PROM measuring what it is intended to measure?)
- •Conclusive pooled estimates from previous systematic reviews indicate strong reproducibility (ie, test-retest, internal consistency) for the region-specific DASH and SPADI.
- •Strong measurement properties were reported across multiple systematic reviews for the WORC, DASH, SPADI, ASES and SST, which could be used in a clinical core set (standardized set of measures that should be gathered and reported as a minimum in all clinical research in specific areas of health or health care
- •Gaps in evidence remain in the lack of evaluation for the measurement properties of validity (eg, known groups, structural) and responsiveness (detecting meaningful change over time) for various shoulder PROMs.
The aim of this study was to synthesize the psychometric evidence on different patient reported outcome measures (PROMs) for shoulder disorders.
This overview conducted a search of six databases. Included systematic reviews must address at least one psychometric property from a PROM for shoulder disorders. Risk of bias was assessed by A MeaSurement Tool to Assess Systematic Reviews (AMSTAR).
Thirteen systematic reviews were identified that assessed measurement properties of 15 different PROMs. Based on AMSTAR, 1 review had a high risk of bias and 7 reviews had a moderate risk of bias. Excellent test-reliability scores of intraclass correlation coefficients (0.85-0.99) were reported by the Disabilities of the Arm, Shoulder and Hand, Shoulder Pain and Dsiability Index, American Shoulder and Elbow Surgeon score and Western Ontario Rotator Cuff Index. Construct validity was supported (r = 0.5-0.8) for the Disabilities of the Arm, Shoulder and Hand, Shoulder Pain and Dsiability Index, American Shoulder and Elbow Surgeon score and Western Ontario Rotator Cuff Index. Limited evidence of responsiveness was reported across various PROMs.
Strong reliability and convergent validity properties have been reported across multiple reviews for the Disabilities of the Arm, Shoulder and Hand, Shoulder Pain and Dsiability Index, American Shoulder and Elbow Surgeon score, Simple Shoulder Test and Western Ontario Rotator Cuff Index, which could be considered for a core clinical outcome set.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Hand Therapy
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Measuring shoulder function: a systematic review of four questionnaires.Arthritis Rheum. 2009; 61: 623-632
- Costs of shoulder pain and resource use in primary health care: a cost-of-illness study in Sweden.BMC Musculoskelet Disord;. 2012; 13: 1-11
- A systematic review of the cross-cultural adaptations and measurement properties of the Shoulder Pain and Disability Index.Hand Therapy. 2019; 24: 107-115
- Psychometric properties of the global rating of change scales in patients with neck disorders: a systematic review with meta-analysis and meta-regression.BMJ open. 2019; 9: e033909
- Overviews of systematic reviews: great promise, greater challenge.Syst Rev. 2017; 6: 1-4
- Patient-Reported outcome measures used for neck disorders: an overview of systematic reviews.J Orthop Sports Phys Ther. 2018; 48: 775-788
- Cochrane Handbook for Systematic Reviews of Interventions.John Wiley & Sons, West Sussex , England2011
- External validation of a measurement tool to assess systematic reviews (AMSTAR).PLoS One. 2007; 2: e1350
- Outcome measures in the management of proximal humeral fractures: a systematic review of their use and psychometric properties.J Shoulder Elbow Surg. 2011; 20: 333-343https://doi.org/10.1016/j.jse.2010.10.028
- A systematic review of the psychometric properties of patient-reported outcome instruments for use in patients with rotator cuff disease.Am J Sports Med. 2015; 43: 2572-2582https://doi.org/10.1177/0363546514565096
- Psychometric properties of self-reported questionnaires for the evaluation of symptoms and functional limitations in individuals with rotator cuff disorders: a systematic review.Disabil Rehabil. 2016; 38: 103-122https://doi.org/10.3109/09638288.2015.1027004
- Evaluation of measurement properties of self-administered PROMs aimed at patients with non-specific shoulder pain and "activity limitations": a systematic review.Qual Life Res. 2016; 25: 2141-2160https://doi.org/10.1007/s11136-016-1277-7
- Application and measurement properties of EQ-5D to measure quality of life in patients with upper extremity orthopaedic disorders: a systematic literature review.Arch Orthop Trauma Surg. 2018; 138: 953-961https://doi.org/10.1007/s00402-018-2933-x
- Minimal clinically important difference of shoulder outcome measures and diagnoses: a systematic review.Am J Phys Med Rehabil. 2019; 98: 671-676
- A systematic review and standardized comparison of available evidence for outcome measures used to evaluate proximal humerus fracture patients.J Orthop Trauma. 2019; 33: e256-e262
- Outcome measures reported for the management of proximal humeral fractures: a systematic review.J Shoulder Elbow Surg. 2020; 29: 2175-2184
- Psychometric properties of patient-reported outcome questionnaires for patients with musculoskeletal disorders of the shoulder.Knee Surg Sports Traumatol Arthrosc. 2019; 27: 3188-3202
- Evaluation of shoulder-specific patient-reported outcome measures: a systematic and standardized comparison of available evidence.J Shoulder Elbow Surg. 2014; 23: 434-444
- The responsiveness of patient-reported outcome tools in shoulder surgery is dependent on the underlying pathological condition.Am J Sports Med. 2019; 47: 241-247
- A systematic review of patient-reported outcome measures used in shoulder instability research.J Shoulder Elbow Surg. 2020; 29: 381-391
- A systematic review of cross-cultural adaptation of the Neck Disability Index.Spine (Phila Pa 1976). 2015; 40: 480-490
- The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content.BMC Med Res Methodol. 2010; 10: 1-8
- Quality criteria were proposed for measurement properties of health status questionnaires.J Clin Epidemiol. 2001; 60: 34-42
- Meta-analysis of correlation coefficients: a Monte Carlo comparison of fixed-and random-effects methods.Psychol Methods. 2001; 6: 161
- A description of the methodology used in an overview of reviews to evaluate evidence on the treatment, harms, diagnosis/classification, prognosis and outcomes used in the management of neck pain.Open Orthop J. 2013; 7: 461
- Psychometric properties of the global rating of change scales in patients with low back pain, upper and lower extremity disorders. A systematic review with meta-analysis.J Orthop. 2020; 21: 40-48
- Physical Rehabilitation Outcome Measures: A Guide to Enhanced Clinical Decision Making.BC Decker, Hamilton, ON2002
- Overcoming Overuse: Improving Musculoskeletal Health Care.J Orthop Sports Phys Ther. 2020; 50: 113-115
- Three key findings when diagnosing shoulder multidirectional instability: patient report of instability, hypermobility, and specific shoulder tests.J Orthop Sports Phys Ther. 2020; 50: 52-54
- An update of systematic reviews examining the effectiveness of conservative physiotherapy interventions for subacromial shoulder pain.J Orthop Sports Phys Ther. 2019; 50: 131-141
- Validity and responsiveness of the short version of the Western Ontario Rotator Cuff Index (Short-WORC) in patients with rotator cuff repair.J Orthop Sports Phys Ther. 2018; 48: 409-418
- Validity of the QuickDASH in patients with shoulder-related disorders undergoing surgery.J Orthop Sports Phys Ther. 2015; 45: 25-36
- A guide to understanding meta-analysis.J Orthop Sports Phys Ther. 2011; 41: 496-504
- Clinimetric evaluation of shoulder disability questionnaires: a systematic review of the literature.Ann Rheum Dis. 2004; 63: 335-341https://doi.org/10.1136/ard.2003.007724
- The increasing complexity of the core outcomes landscape.J Clin Epidemiol. 2019; 116: 150-154
- Core domain and outcome measurement sets for shoulder pain trials are needed: systematic review of physical therapy trials.J Clin Epidemiol. 2015; 68: 1270-1281
JHT Read for Credit
Quiz: # 858
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.Risk of bias was assessed using
- # 2.The authors sought to identify
- a.core sets of outcome measures
- b.core concepts for treatment of shoulder pathology
- c.resources for guiding treatment protocols for shoulder injuries
- d.barriers to effective management of post-op shoulder conditions
- # 3.The search produced
- a.500 articles of which 25 were finally included
- b.500 articles of which 50 were finally included
- c.650 articles of which 60 were finally included
- d.650 articles of which 30 were finally included
- # 4.Discriminative validity was assessed in the population of
- a.rotator cuff impingement syndrome
- b.anterior instability
- c.non-specific shoulder pain
- d.biceps tendon rupture
- # 5.A single PROM was identified as the gold standard for clinical use following rehabilitation for shoulder pathology
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Published online: April 29, 2022
Accepted: March 27, 2022
Received in revised form: January 8, 2022
Received: December 30, 2020
© 2022 Elsevier Inc. All rights reserved.