Abstract
Background
The Single Assessment Numeric Evaluation (SANE) is a single item patient reported
outcome measure (PROM) of function, in where patients rate how normal they feel in
relation to a specific joint or problem. Although validated for some orthopedic conditions,
it is not yet validated for a population with shoulder pathologies; nor have other
studies explored the content validity. This study aims to understand how 1) patients
with shoulder conditions interpret and calibrate responses to the SANE and 2) how
they define normal.
Methods
This study uses cognitive interviewing, a qualitative methodology that focuses on
the interpretation of questionnaire items. Patients with rotator cuff disorders (n = 10),
clinicians (n = 6) and measurement researchers (n = 10) were interviewed using a talk
aloud structured interview that evaluated the SANE. All interviews were recorded and
transcribed verbatim by one researcher (R.F). Analysis was done through an open coding
scheme using a previously established framework for classification of interpretation
variances.
Results
Overall, the single-item SANE was well received by all participants. Through the interviews,
the themes of: Comprehension (20% of participants), Reference Point (20% of participants),
Relevance (10% of participants), and Perspective Modifiers (50% of participants) emerged
as potential sources of interpretation variances. Clinicians indicated this tool facilitates
discussion when trying to create realistic recovery expectations for patients post-operatively.
The word “normal” was defined by the themes of: 1) levels of current pain compared
to pre-injury, 2) personal expectations of recovery and 3) pre-injury activity levels.
Conclusions
Overall, respondents found the SANE to be cognitively simple, but it was clear that
the interpretation of the question and what factors calibrated their responses were
highly variable between respondents. The SANE is perceived favorable by patients and
clinicians, while providing a low response burden. However, the construct being measured
may vary between patients.
Keywords
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Article info
Publication history
Published online: March 11, 2023
Accepted:
October 14,
2022
Received in revised form:
April 28,
2022
Received:
October 13,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
