Responsiveness of outcome measures in patients with superior labral anterior and posterior lesions

Abstract

Background: Evaluation of patients with superior labral anterior and posterior (SLAP) lesions requires outcome measures validated for the purpose. The present study aimed to evaluate the responsiveness of the Rowe score, Oxford Instability Shoulder Score (OISS), Western Ontario Shoulder Instability Index (WOSI) and EuroQol (EQ-5D and EQ-VAS) in patients treated for SLAP lesions. Methods: Eighty-nine patients were included: 34 had arthroscopic labral repair, 28 had mini-open biceps tenodesis and 27 had physical treatment. The outcome measures were administrated before treatment and after 6 months. Responsiveness was evaluated using standardized response mean (SRM), area under receiver-operating characteristic curve (ROCAUC), reliable chance proportion (RCP) statistics and hypothesis testing. Minimal clinically important change (MCIC) estimates were reported. Results: All outcome measures had high values of SRM (0.86-1.92). RCPs for the improved group were 68% to 79% for OISS, WOSI and Rowe score, and 15% to 49% for EuroQol. ROCAUC was >0.70 for all outcomes. MCIC estimates were 8 and 10 for OISS; 451 and 569 for WOSI; 17 and 18 for Rowe score; 0.39 and 0.53 for EQ-5D; and 35 and 41 for EQ-VAS. Responsiveness tested with hypotheses favours the shoulder-specific outcomes. Conclusions: OISS, WOSI and Rowe score are more responsive than EuroQol in evaluation of patients with SLAP lesions.

Long-Term Results After SLAP Repair: A 5-Year Follow-up Study of 107 Patients With Comparison of Patients Aged Over and Under 40 Years

“…Assuming 10% dropout, we planned to include 40 patients in each group. In a later study by Skare et al,[93][94][95] we found the minimal clinically important change for Rowe to be 17. At 6 months, there were no cross-overs, and the results were analyzed and interpreted blindly, as recommended by Järvinen et al96 Continuous variables were presented as mean values with 95% CI and categorical values as numbers and percentages.…”

“…102 The outcome measures for the same group of patients were validated particularly for the present study. [93][94][95] Our group ran parallel studies validating the Rowe score, the Western Ontario Shoulder Index, and the Oxford Instability Shoulder Score. The ideal situation would have been to have the minimal clinical important difference (MCID) calculated before designing the study.…”

Return to Play and Outcomes in Baseball Players After Superior Labral Anterior-Posterior Repairs

“…This questionnaire included questions detailing their RTP, competition level to which they returned, return to preinjury performance, WOSI, and the VR-12. The WOSI was selected as it has been previously validated for use in post-SLAP repair populations to assess shoulder function, 34,35 and the VR-12 was chosen as it is a widely used general quality of life measure. Patients who were active baseball players at the time of follow-up also completed a Kerlan-Jobe Orthopaedic Clinic (KJOC) score, as Neri et al 25 demonstrated the KJOC score better replicates the true outcome of overhead throwers versus other shoulder outcome scores.…”

The Fear Avoidance Beliefs Questionnaire – the FABQ – for the benefit of another 70 million potential pain patients

“…FABQ is reported to be rather unresponsive but vary according to the effectiveness of the intervention and other factors that Ibrahim et al have discussed [4,5]. The Responsiveness is usually measured by hypothesis testing and the receiver operating characteristic curve (ROC-curve) as discussed by Ibrahim et al By using this method, it is possible to estimate the Minimally Important Clinical Difference, which is helpful in the clinical interpretation of change scores [6,7]. The ROC curve assesses the ability to discriminate between patients who report improvement and those who do not report important change on a global change score.…”