Measuring shoulder injury function: common scales and checklists

Area of Science:

• Orthopaedic surgery
• Patient-reported outcome measures (PROMs)
• Clinical assessment

Background:

• Patient-centered care necessitates validated PROMs for functional outcomes in orthopaedics.
• Existing shoulder outcome instruments are often designed for chronic conditions, not acute trauma.
• Assessing psychometric properties in the specific patient population is crucial for instrument validity.

Purpose of the Study:

• To review four common shoulder outcome instruments: American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), Constant-Murley shoulder score (CMS), Disabilities of Arm, Shoulder, and Hand (DASH), and Oxford Shoulder Score (OSS).
• To evaluate the psychometric properties (validity, reliability, responsiveness, interpretability, floor/ceiling effects) of these instruments.
• To assess the available evidence supporting their use in shoulder trauma populations.

Main Methods:

• Literature review of psychometric evidence for ASES, CMS, DASH, and OSS.
• Focus on studies involving shoulder fracture populations.
• Analysis of instrument properties including validity, reliability, responsiveness, and interpretability.

Main Results:

• Limited psychometric evidence supports the use of ASES, CMS, DASH, and OSS in shoulder trauma populations.
• Evidence for these instruments' performance in isolated shoulder fracture patients is scarce.
• Instrument properties are population-specific and may not generalize to trauma patients.

Conclusions:

• Clinicians should exercise caution when using shoulder outcome instruments not fully evaluated in trauma populations.
• Further research is needed to establish the psychometric properties of PROMs in shoulder fracture patients.
• The selection of appropriate outcome measures requires careful consideration of the target population's characteristics.