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Updated: Jan 27, 2026

Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Do older adults with shoulder disorders who meet the minimal clinically important difference also present low
Alessandra Narciso Garcia1, Charles A Thigpen2, Ashley Davis Lake3
1Post-Doctorate, Doctor of Physical Therapy Division, Department of Orthopaedic Surgery, Duke University, 2200 W. Main St. Durham, NC, USA 27708.
Background:
The choice of outcome success thresholds may influence clinical management, pay-for-performance, and assessment of value-based care.
Objective:
To evaluate outcomes success thresholds in older adults using two different methods: 1) Minimal clinically important differences (MCIDs) of the Quick-DASH and 2) Dichotomization of the Quick-DASH based on low disability rating at discharge DESIGN: An observational design (retrospective database study).
Setting:
Dataset of 1109 patients with shoulder disorders.
Participants:
297 older adults patients who were diagnosed with rotator cuff related shoulder disorders and were managed through physical therapy treatment.
Main Outcome Measures:
We categorized and calculated how many patients met 8.0 and 16.0 point changes on the Quick-DASH. To evaluate outcomes success thresholds using dichotomization, patients who discharge score of ≤20 on the Quick-DASH were considered positive responders with successful outcomes.
Results:
The percentage of positive responders who met the MCID thresholds for the Quick-DASH were 63.3% using MCID of 8.0 points, 39.7% using the MCID of 16.0 points, and 46.12% who met discharge score of ≤ 20 on the Quick-DASH. 39.0% met both MCID of 8.0 points and discharge score of ≤ 20 on the Quick-DASH. Only 28% met both MCID of 16.0 points and discharge score of = 20 on the Quick-DASH.
Conclusion:
Three different success threshold derivations classified patients into three very different assessments of success. Quick-DASH scores of ≤ 20 represent low levels of self-report disability at discharge and can be a stable clinical option for a measure of success to capture whether a treatment results in meaningful improvement.
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