Self-assessment of general health status in patients with five common shoulder conditions

Gartsman, Gary M.; Brinker, Mark R.; Khan, Myrna; Karahan, Mustafa

doi:10.1016/s1058-2746(98)90050-7

Cited by 176 publications

(107 citation statements)

References 17 publications

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“…1,2 Neck and shoulder disorders are the second most prevalent MSK condition 3,4 and are reported to affect people's perception of health-related quality of life (QOL). [5][6][7] Of all specialists, orthopaedic surgeons are the most commonly consulted for MSK problems, 1 and approximately 37% of ambulatory encounters with orthopaedic surgeons in Canada and the United States are reported to be for arthritis and related conditions. 8,9 In Ontario, the Ministry of Health and Long-Term Care has proposed 189 days as the waittime target for shoulder surgery, but wait times remained as high as 543 days for some hospitals in 2011 and 436 days in 2012.…”

mentioning

confidence: 99%

Evaluation of an Advanced-Practice Physical Therapist in a Specialty Shoulder Clinic: Diagnostic Agreement and Effect on Wait Times

Razmjou

Robarts

Kennedy

et al. 2013

Physiotherapy Canada

107

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Purpose: To examine the role of an advanced-practice physiotherapist (APP) with respect to (1) agreement with an orthopaedic surgeon on diagnosis and management of patients with shoulder problems; (2) wait times; and (3) satisfaction with care. Methods: This prospective study involved patients with shoulder complaints who were referred to a shoulder specialist in a tertiary care centre. Agreement was examined on seven major diagnostic categories, need for further examination and surgery, and type of surgical procedure. Wait times were compared between the APP-and surgeon-led clinics from referral date to date of initial consultation, date of final diagnostic test, and date of confirmed diagnosis and planned treatment. A modified and validated version of the Visit-Specific Satisfaction Instrument assessed satisfaction in seven domains. Kappa (k) coefficients and bias-and prevalence-adjusted kappa (PABAK) values were calculated, and strength of agreement was categorized. Wait time and satisfaction data were examined using non-parametric statistics. Results: Agreement on major diagnostic categories varied from 0.68 (good) to 0.96 (excellent). Agreement with respect to indication for surgery was k ¼ 0.75, p < 0.001; 95% CI, 0.62-0.88 (good). Wait time for APP assessment was significantly shorter than wait time for surgeon consultation at all time points (p < 0.001); the surgeon's wait time was significantly reduced over 3 years. High satisfaction was reported in all components of care received from both health care providers. Conclusions: Using experienced physiotherapists in an extended role reduces wait times without compromising patient clinical management and overall satisfaction.Key Words: advanced practice; diagnosis; physiotherapist; shoulder. RÉ SUMÉObjectif : Examiner le rô le du physiothé rapeute en pratique avancé e en ce qui a trait (1) aux accords avec un chirurgien orthopé dique sur le diagnostic et la gestion de patients aux prises avec des problè mes à l'é paule; (2) au temps d'attente; (3) à la satisfaction par rapport aux soins. Mé thode : Cette é tude prospective a fait appel à des patients avec des douleurs à l'é paule qui ont é té dirigé s vers des spé cialistes de l'é paule dans un centre de soins tertiaires. Les accords ont é té examiné s pour sept caté gories de diagnostics, en fonction de la né cessité d'examens plus poussé s ou de chirurgie et du type d'intervention chirurgicale projeté . On a comparé les temps d'attente pour le physiothé rapeute en pratique avancé e et les cliniques dirigé es par un chirurgien à partir de la date où le patient a é té redirigé à la consultation initiale, jusqu'à la date de diagnostic dé finitif, jusqu'à la date de diagnostic confirmé et jusqu'au traitement planifié . Une version modifié e et validé e de l'instrument d'é valuation de la satisfaction à la suite d'une consultation (VisitSpecific Satisfaction Instrument ) a permis de mesurer la satisfaction dans sept domaines. Les coefficients kappa (k) et les valeurs kappa ajusté es pour la pré valence...

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confidence: 99%

Evaluation of an Advanced-Practice Physical Therapist in a Specialty Shoulder Clinic: Diagnostic Agreement and Effect on Wait Times

Razmjou

Robarts

Kennedy

et al. 2013

Physiotherapy Canada

107

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“…PROMs can be used to study the impact of disease or injury on health status. At our institution, we have studied how health status is affected by shoulder conditions [38], knee conditions [69], and nonunions of various long bones [11,12]. These studies show that many orthopaedic conditions are very disabling, resulting in physical functioning scores in the lowest quartile of the US population and well below many chronic disease states viewed as disabling.…”

Section: Types Of Studiesmentioning

confidence: 99%

Stakeholders in Outcome Measures: Review From a Clinical Perspective

Brinker

O’Connor

2013

Clinical Orthopaedics &Amp; Related Research

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“…Patients suffering from glenohumeral osteoarthritis experience significant discomfort, loss of function, and a decreased quality of life. In terms of its effect on patient health status, as measured by the SF-36, glenohumeral osteoarthritis is comparable to diseases such as congestive heart failure, acute myocardial infarction, and diabetes mellitus [7]. Treatment options are influenced by patient age, severity of symptoms, medical comorbidities, radiographic findings, and patient characteristics.…”

Section: Introductionmentioning

confidence: 99%

High Incidence of Hemiarthroplasty for Shoulder Osteoarthritis Among Recently Graduated Orthopaedic Surgeons

Mann

Baumhauer

O’Keefe

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Primary glenohumeral osteoarthritis is a common indication for shoulder arthroplasty. Historically, both total shoulder arthroplasty (TSA) and hemi-shoulder arthroplasty (HSA) have been used to treat primary glenohumeral osteoarthritis. The choice between procedures is a topic of debate, with HSA proponents arguing that it is less invasive, faster, less expensive, and technically less demanding, with quality of life outcomes equivalent to those of TSA. More recent evidence suggests TSA is superior in terms of pain relief, function, ROM, strength, and patient satisfaction. We therefore investigated the practice of recently graduated orthopaedic surgeons pertaining to the surgical treatment of this disease. Questions/purposes We hypothesized that (1) recently graduated, board eligible, orthopaedic surgeons with fellowship training in shoulder surgery are more likely to perform TSA than surgeons without this training; (2) younger patients are more likely to receive HSA than TSA; (3) patient sex affects the choice of surgery; (4) US geographic region affects practice patterns; and (5) complication rates for HSA and TSA are not different.

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Self-assessment of general health status in patients with five common shoulder conditions

Cited by 176 publications

References 17 publications

Evaluation of an Advanced-Practice Physical Therapist in a Specialty Shoulder Clinic: Diagnostic Agreement and Effect on Wait Times

Evaluation of an Advanced-Practice Physical Therapist in a Specialty Shoulder Clinic: Diagnostic Agreement and Effect on Wait Times

Stakeholders in Outcome Measures: Review From a Clinical Perspective

High Incidence of Hemiarthroplasty for Shoulder Osteoarthritis Among Recently Graduated Orthopaedic Surgeons

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