A Shortened Version of the Western Ontario Rotator Cuff Disability Index: Development and Measurement Properties

Abstract

Purpose: The objective of this study was to develop and examine the measurement properties of a shortened version of the Western Ontario Rotator Cuff Index (WORC), the SHORTWORC, in individuals with rotator-cuff pathology. Methods: The study occurred in two stages, both using secondary analysis of existing data sets. The first stage used cross-sectional data from candidates for rotator-cuff surgery to develop the SHORTWORC. The second stage examined various measurement properties of the SHORTWORC by analyzing scores from the WORC, the American Shoulder and Elbow Surgeons questionnaire, and the Constant-Murley score obtained from patients before and after rotator-cuff surgery. Approaches to validating the SHORTWORC included calculating the standard error of measurement (SEM) at an instant in time, performing a confirmatory factor analysis, correlating findings among the questionnaires, and examining differences between men and women. Sensitivity to change was investigated using standardized response mean and relative efficiency. Results: Data for 712 patients were used to develop the SHORTWORC, the final version of which consisted of 7 questions. Data for 166 patients (86 men, 80 women; mean age 57 e 11 years) were used for validation. The SEM based on internal consistency (SEM IC ) was calculated as 7.43 SHORTWORC points. The SHORTWORC had similar convergent validity (r ¼ 0.72 À 0.82) and sensitivity to change (SRM ¼ 1.20 vs. 1.25, p > 0.05) to the longer version. The relative efficiency of the SHORTWORC was 3.19 times that of the WORC (95% CI, 1.50-71.51) in discriminating men's from women's level of disability. Conclusions: The SHORTWORC has indicators of validity, relative efficiency, and sensitivity to change comparable to those of the original version but has a smaller response burden.Key Words: outcome measures; reliability of results; shortened version; validity of results; WORC. RÉ SUMÉObjectif : L'objectif de cette é tude é tait de cré er et d'analyser les proprié té s de mesure d'une version abré gé e du Western Ontario Rotator Cuff Index (WORC), le SHORTWORC, chez les personnes aux prises avec une pathologie de la coiffe des rotateurs. Mé thode : Ce projet s'est dé roulé en deux é tapes. Une analyse secondaire des ensembles de donné es existants a é té ré alisé e à chacune d'elles. La premiè re a fait appel à des donné es transversales de candidats à une intervention chirurgicale pour la coiffe des rotateurs pour l'é laboration de l'indice abré gé SHORTWORC. La deuxiè me é tape s'est penché e sur les diverses proprié té s de mesure de l'indice SHORTWORC en analysant les pointages obtenus dans le cadre du WORC, les ré sultats au questionnaire de l'American Shoulder and Elbow Surgeons et les indices de l'é chelle Constant-Murley; tous ont é té obtenus auprè s des patients avant intervention chirurgicale pour la coiffe des rotateurs. Les outils de validation du SHORTWORC comprenaient notamment l'erreur type de mesure (ETM) à un point pré cis dans le temps, l'analyse du facteur de confirmation, la...

Interpretation and content validity of the items of the numeric rating version short-WORC to evaluate outcomes in management of rotator cuff pathology: a cognitive interview approach

“…Finally, it is evident that the recall period was accurately evaluated and participants found no difficulty in that process. Therefore, it is evident that the Short-WORC demonstrates aspects of content validation in the intended population, and qualitatively supports aspects of our prior work [1,6,8].…”

“…While it has been translated and validated in a variety of different languages [1,2], the WORC created challenges of patient response burden (time spent to answer questionnaire) and complexity identified through patient interviews and statistical methods [1,2] A shortened version of the Western Ontario Rotator Cuff Index (Short-WORC) was created to address these concerns [6,7]. The Short-WORC by Razmjou et al contains seven items from the domains of work and lifestyle, focusing on the activity limitations that arise from RCDs [1,4,6,8]. Previously, participants completed a visual analogue scale (VAS) to score their response [6], however, in the present study we have modified the responsiveness scale to a 0-10-point numeric scale.…”

“…The Short-WORC by Razmjou et al contains seven items from the domains of work and lifestyle, focusing on the activity limitations that arise from RCDs [1,4,6,8]. Previously, participants completed a visual analogue scale (VAS) to score their response [6], however, in the present study we have modified the responsiveness scale to a 0-10-point numeric scale. According to previously literature, the use of a numeric scale reduces patient response burden and increases patient satisfaction [9].…”

Relationship between clinical and surgical findings and reparability of large and massive rotator cuff tears: a longitudinal study

“…All outcomes have been reported to be valid and reliable in patients with rotator cuff pathology [22-26]. Level of co-morbidity (0-52) was calculated as continuous data based on a validated score, the Cumulative Illness Rating Scale [27] which examines the overall health.…”

Interpretation and content validity of the items of the numeric rating version Short-WORC to evaluate outcomes in management of rotator cuff pathology: A cognitive interview approach.

“…5 While it has been translated and validated in a variety of different languages 1,2 , the WORC created challenges of patient response burden (time spent to answer questionnaire) and complexity identified through patient interviews and statistical methods 1,2 A shortened version of the Western Ontario Rotator Cuff Index (Short-WORC) was created to address these concerns. 7,27 The Short-WORC by Razmjou et al contains seven items from the domains of work and lifestyle, focusing on the activity limitations that arise from RCDs. 1,4,6,7 Previously, participants completed a visual analogue scale (VAS) to score their response, 7 however, in the present study we have modified the responsiveness scale to a 0-10-point numeric scale.…”