Øystein Skare1,2, Jostein Skranes Brox3, Cecilie Piene Schrøder4, Jens Ivar Brox5,6. 1. Surgical Department, Lovisenberg Diaconal Hospital, Oslo, Norway. oystein.skare@lds.no. 2. Orthopedic Department, Lovisenberg Diaconal Hospital, Lovisenberggt 17, 0440, Oslo, Norway. oystein.skare@lds.no. 3. Copenhagen Business School, Copenhagen, Denmark. 4. Surgical Department, Lovisenberg Diaconal Hospital, Oslo, Norway. 5. Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway. 6. Medical Faculty, University of Oslo, Oslo, Norway.
Abstract
BACKGROUND: To assess responsiveness of five outcome measures at four different follow-ups in patients with SLAP II lesions of the shoulder. METHODS: 119 patients with symptoms and signs, MRI arthrography and arthroscopic findings were included. The Western Ontario Shoulder Instability Index (WOSI), Oxford Instability Shoulder Score (OISS), EuroQol (EQ-5D3L), Rowe Score and Constant-Murley Score (CMS) were assessed at baseline, 3, 6, 12 and 24 months. The analysis contains both anchor-based and distribution-based methods, and hypothesis testing. RESULTS: Confidence intervals for ROC cut-off values, representing MID, for OISS, CMS and EQ-5D3L crossed zero at 3 months. Cut-off values were stable between 6- and 24-months follow-up. At 24-months ROC cut-off values (95% CI) were: Rowe 18 (13 to 24); WOSI 331 (289 to 442); OISS 9 (5 to 14); CMS 11 (9 to 15) and EQ-5D3L 0.123 (0.035 to 0.222). MID95%limit estimates were substantially higher than ROC cut-off values and MIDMEAN at all follow-ups for all instruments. The reliable change proportion (RCP) values in the improved group were highest for WOSI and the Rowe Score (ranging from 68 to 87%) and significantly lower for CMS. EQ-5D3L had the lowest values (13 to 16%). We found a moderate correlation between mean change scores of the outcome measures and the anchor, except for the EQ-5D3L. CONCLUSIONS: In patients with SLAP II-lesions the patient reported OISS and WOSI and the clinical Rowe score had best responsiveness. Our results suggest that 3 months follow-up is too early for outcome evaluation.
BACKGROUND: To assess responsiveness of five outcome measures at four different follow-ups in patients with SLAP II lesions of the shoulder. METHODS: 119 patients with symptoms and signs, MRI arthrography and arthroscopic findings were included. The Western Ontario Shoulder Instability Index (WOSI), Oxford Instability Shoulder Score (OISS), EuroQol (EQ-5D3L), Rowe Score and Constant-Murley Score (CMS) were assessed at baseline, 3, 6, 12 and 24 months. The analysis contains both anchor-based and distribution-based methods, and hypothesis testing. RESULTS: Confidence intervals for ROC cut-off values, representing MID, for OISS, CMS and EQ-5D3L crossed zero at 3 months. Cut-off values were stable between 6- and 24-months follow-up. At 24-months ROC cut-off values (95% CI) were: Rowe 18 (13 to 24); WOSI 331 (289 to 442); OISS 9 (5 to 14); CMS 11 (9 to 15) and EQ-5D3L 0.123 (0.035 to 0.222). MID95%limit estimates were substantially higher than ROC cut-off values and MIDMEAN at all follow-ups for all instruments. The reliable change proportion (RCP) values in the improved group were highest for WOSI and the Rowe Score (ranging from 68 to 87%) and significantly lower for CMS. EQ-5D3L had the lowest values (13 to 16%). We found a moderate correlation between mean change scores of the outcome measures and the anchor, except for the EQ-5D3L. CONCLUSIONS: In patients with SLAP II-lesions the patient reported OISS and WOSI and the clinical Rowe score had best responsiveness. Our results suggest that 3 months follow-up is too early for outcome evaluation.
Authors: Caroline B Terwee; Sandra D M Bot; Michael R de Boer; Daniëlle A W M van der Windt; Dirk L Knol; Joost Dekker; Lex M Bouter; Henrica C W de Vet Journal: J Clin Epidemiol Date: 2006-08-24 Impact factor: 6.437
Authors: Albit R Paoli; Heather T Gold; Siddharth A Mahure; David H Mai; Christoph A Agten; Andrew S Rokito; Mandeep S Virk Journal: Arthroscopy Date: 2018-04-10 Impact factor: 4.772