Keith M Baumgarten1. 1. Orthopedic Institute. Sioux Falls, SD, USA; University of South Dakota Sanford School of Medicine. Sioux Falls, SD, USA. Electronic address: Kbaumga@yahoo.com.
Abstract
BACKGROUND/HYPOTHESIS: The purpose of this study was to compare the correlation, responsiveness, and responder and administrator burden of the American Shoulder and Elbow Surgeons score (ASES) with the Western Ontario Osteoarthritis Score (WOOS) for patients undergoing total shoulder arthroplasty. The goal was to determine if one score was superior to the other in order to limit the use of multiple scoring measures when tracking patient outcomes. The hypothesis of this study is that for patients undergoing total shoulder arthroplasty the WOOS will have 1) a high level of correlation with the ASES, 2) have comparable responsiveness, and 3) have a higher responder and administrator burden than the ASES. METHODS: A retrospective review of a database of patients undergoing total shoulder arthroplasty was reviewed where the ASES was recorded with the WOOS. Correlations were determined using the Pearson coefficient. Sub-group analysis was performed to determine if correlations differed in 1) preoperative outcome and 2) postoperative outcome determinations and by type of arthroplasty (anatomic vs reverse). Responsiveness was determined by calculating the standardized response mean (SRM) and the effect size (ES) of both scores. Responder and administrator burden was examined using 50 consecutive preoperative patients to determine the number of incorrectly completed WOOS and ASES scores. RESULTS: Correlation was excellent for the ASES and WOOS (n=1218; r=0.88; p<0.0001). The correlation of ASES and WOOS was excellent for patients undergoing anatomic total shoulder arthroplasty (n = 695; r = 0.71; p<0.0001) and reverse total shoulder arthroplasty (n=523; r = 0.88; p<0.0001). The correlation of preoperative scores was strong-moderate (n=606; r=0.62; p<0.0001) and postoperative scores was strong-moderate (n=612; r=0.69; p<0.0001). The SRM (WOOS=2.1; ASES=2.1) and the ES (WOOS = 3.0; ASES = 3.0) demonstrated comparable responsiveness. 26% of the WOOS were completed incorrectly and were invalid compared to 0% for the ASES (p<0.0001). CONCLUSION: There is excellent correlation and comparable responsiveness between the ASES and WOOS. Including these scores simultaneously in tracking patient-determined outcomes appears to be redundant and therefore unnecessary. Since there is higher responder and administrative burden for the WOOS score, the authors recommend utilization of the ASES over the WOOS in patients undergoing total shoulder arthroplasty.
BACKGROUND/HYPOTHESIS: The purpose of this study was to compare the correlation, responsiveness, and responder and administrator burden of the American Shoulder and Elbow Surgeons score (ASES) with the Western Ontario Osteoarthritis Score (WOOS) for patients undergoing total shoulder arthroplasty. The goal was to determine if one score was superior to the other in order to limit the use of multiple scoring measures when tracking patient outcomes. The hypothesis of this study is that for patients undergoing total shoulder arthroplasty the WOOS will have 1) a high level of correlation with the ASES, 2) have comparable responsiveness, and 3) have a higher responder and administrator burden than the ASES. METHODS: A retrospective review of a database of patients undergoing total shoulder arthroplasty was reviewed where the ASES was recorded with the WOOS. Correlations were determined using the Pearson coefficient. Sub-group analysis was performed to determine if correlations differed in 1) preoperative outcome and 2) postoperative outcome determinations and by type of arthroplasty (anatomic vs reverse). Responsiveness was determined by calculating the standardized response mean (SRM) and the effect size (ES) of both scores. Responder and administrator burden was examined using 50 consecutive preoperative patients to determine the number of incorrectly completed WOOS and ASES scores. RESULTS: Correlation was excellent for the ASES and WOOS (n=1218; r=0.88; p<0.0001). The correlation of ASES and WOOS was excellent for patients undergoing anatomic total shoulder arthroplasty (n = 695; r = 0.71; p<0.0001) and reverse total shoulder arthroplasty (n=523; r = 0.88; p<0.0001). The correlation of preoperative scores was strong-moderate (n=606; r=0.62; p<0.0001) and postoperative scores was strong-moderate (n=612; r=0.69; p<0.0001). The SRM (WOOS=2.1; ASES=2.1) and the ES (WOOS = 3.0; ASES = 3.0) demonstrated comparable responsiveness. 26% of the WOOS were completed incorrectly and were invalid compared to 0% for the ASES (p<0.0001). CONCLUSION: There is excellent correlation and comparable responsiveness between the ASES and WOOS. Including these scores simultaneously in tracking patient-determined outcomes appears to be redundant and therefore unnecessary. Since there is higher responder and administrative burden for the WOOS score, the authors recommend utilization of the ASES over the WOOS in patients undergoing total shoulder arthroplasty.