Usage Trends of Patient-reported Outcome Measures in Shoulder Literature

Abstract

Introduction: Quantifying patient outcomes is integral in orthopaedic practice, and patient-reported outcome measures (PROMs) assist with this goal and assist clinicians in assessing subjective outcomes (pain, satisfaction, etc.). This study seeks to identify the most highly used PROMs in the shoulder literature and analyze their usage trends. Methods: PubMed was queried for all shoulder-based articles published in eight selected journals from 2007 to 2017. Articles were assessed for PROM usage, surgical approach, surgical procedure, and disease pathology. Frequency analyses identified the most used PROMs overall, and for each approach, procedure, and pathology. Last, usage trends, question number, validation, and clinician dependence of PROMs with ≥20 uses were analyzed. Results: In total, 1,740 of 2,462 articles (71%) used 105 unique PROMs 4,394 times during the study. PROM usage increased 18%, and the use of multiple PROMs increased by 20%. PROMs with a clinician component increased 21% slower than the baseline. Twenty-two PROMs (17%) had >20 uses, with the most used PROMs being the Constant-Murley Score (783), American Shoulder and Elbow Surgeons Shoulder Score (731), Visual Analog Scale (685), Simple Shoulder Test (372), and the University of California, Los Angeles, Shoulder Rating Scale (274). PROMs demonstrating the greatest usage increase were the EuroQol 5-Dimensions Questionnaire (1,282%), Shoulder Pain and Disability Index (638%), Western Ontario Rotator Cuff Index (632%), Western Ontario Osteoarthritis of the Shoulder Index (582%), and Oxford Shoulder Score (462%)—all without a clinician component. Discussion: PROM usage is increasing, often with multiple PROMs being used to evaluate patient outcomes. PROMs without a clinician component are growing at higher rates than their clinician-dependent counterparts, highlighting an emphasis on patient reporting of outcomes. This study suggests that the American Shoulder and Elbow Surgeons Shoulder Score, Oxford Shoulder Score, Visual Analog Scales—all without a mandatory clinician component and high levels of use—will be the most highly used PROMs moving forward to assess shoulder function.

Implantable Subacromial Balloon Spacers in Patients With Massive Irreparable Rotator Cuff Tears: A Systematic Review of Clinical, Biomechanical, and Financial Implications

“…24 The biodegradable spacer is composed of a copolymer material that lasts for approximately 12 months before full degradation occurs. 24 Reported advantages of this device are its minimal technical demands and shorter operative duration, 7,24,25 evidence of expedited postoperative shoulder mobility, 26 and improved postoperative clinical function scores, such as Total Constant Score (TCS), American Shoulder and Elbow Surgeons (ASES) score, and Oxford Shoulder Score (OSS) in patients, [27][28][29] and the ability to implant the device under fluoroscopic guidance without general anesthesia in those patients with medical contraindications. 7,25 Recent systematic reviews by Moon et al 29 and Stewart et al 30 demonstrated improvements in patient satisfaction and clinical outcomes such as TCS and ASES in patients managed with subacromial balloon spacers.…”

„Patient-reported outcome measures“ (PROMs) in der Schulter- und Ellenbogenchirurgie

“…Die weltweit am häufigsten genutzten PROMs in Studien zu Schulterpathologien sind laut einer Analyse von Mosher et al [37] der Constant-Murley Score (CS), der American Shoulder and Elbow Surgeons Shoulder Form (ASES), die Visual Analog Scale (VAS), der Simple Shoulder Test (SST) und die University of California, Los Angeles, Shoulder Rating Scale (UCLA). Laut einer Analyse von Booker et al [37] bestehen jedoch Unterschiede in der internationalen Nutzung von Schulter-PROMs. Insbesondere der Oxford Shoulder Score (OSS) wird im europäischen Raum häufiger genutzt als in der amerikanischen Literatur [37].…”

“…Laut einer Analyse von Booker et al [37] bestehen jedoch Unterschiede in der internationalen Nutzung von Schulter-PROMs. Insbesondere der Oxford Shoulder Score (OSS) wird im europäischen Raum häufiger genutzt als in der amerikanischen Literatur [37].…”

“…Der ASES ist somit ein PROM, der durch die Sicht des Klinikers ergänzt werden kann. Er ist der weltweit am zweithäufigsten angewand-te Schulterscore und der am häufigsten genutzte Score für Studien zu offenen Operationsverfahren wie der Implantation von Schulterprothesen oder nichtoperativen Behandlungen [37]. Der ASES ist einfach und unabhängig der Diagnose bei allen Schulterpatienten anwendbar.…”

“…Mit 35 zu 65 Punkten machen die vom Patienten erfassten Parameter den kleineren Anteil aus. Der CS ist der weltweit am häufigsten verwendete Schulterscore und wird führend bei Studien zu arthroskopischen Eingriffen wie Rotatorenmanschettenrekonstruktionen, bei glenohumeralen Stabilisierungen und bei Humeruskopffrakturen verwendet [37]. Er ist leicht anzuwenden und aufgrund seiner langfristigen Verwendung ermöglicht er den Vergleich von älteren in der Literatur berichteten Behandlungsergebnisse mitmodernerenchirurgischenoder nichtchirurgischen Therapien [37].…”