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Shoulder outcome measures: is there a right answer?

James E Beastall1,2, Shona Fielding3, Eva Christie4

  • 1Department of Orthopaedic Surgery, Aberdeen Royal Infirmary, Foresterhill Road, Aberdeen, UK. james.beastall@nhs.net.

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
|January 28, 2016
PubMed
Summary

Different shoulder outcome measures yield varied results, impacting clinical assessments. Clinicians must carefully select instruments based on their specific goals for accurate patient evaluation.

Keywords:
Outcome measuresProximal humeral fracturesScoring systems

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Area of Science:

  • Orthopedics
  • Clinical Outcomes Research
  • Musculoskeletal Health

Background:

  • Shoulder pain and function assessment relies on various outcome measures.
  • A definitive 'gold standard' for shoulder assessment is lacking.
  • Existing instruments may produce differing results.

Purpose of the Study:

  • To statistically compare four common shoulder outcome measures.
  • To determine if combined objective/subjective instruments differ from purely subjective ones.
  • Focus on trauma patients with proximal humeral fractures.

Main Methods:

  • Recruited 44 patients with proximal humeral fractures.
  • Administered University of Los Angeles (UCLA) score, Constant and Murley score (Constant), Oxford Shoulder Score (OSS), and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire.
  • Standardized all scores to a 0-100 scale for comparison.

Main Results:

  • Purely subjective instruments reported higher scores, indicating better function or less pain.
  • Significant statistical differences (p < 0.001) were found between most instrument pairs.
  • No significant difference was observed between UCLA and QuickDASH (p = 0.403).
  • Inconsistencies noted, with outcomes varying based on subjective vs. objective components.

Conclusions:

  • Shoulder outcome measures are valuable clinical tools.
  • Clinicians must exercise caution when selecting instruments.
  • Instrument choice should align with the specific purpose of outcome assessment.