Mumbai shoulder score: validation of a new patient-reported shoulder outcome score for evaluating shoulder pain and...

The criticisms of the current patient-reported outcome measure (PROM) scores are that they are laborious, may be difficult for the patients to understand, and some may require a license for their use. Therefore, the purpose of the study was to validate a new PROM scoring system.

A new shoulder scoring questionnaire was developed after interviewing 50 patients and refined after testing in 20 additional patients. The new score, "Mumbai shoulder score (MSS)," consisted of 10 questions with 4 response options. The score evaluates shoulder pain and difficulties in tasks such as reaching top shelves, hanging clothes, braiding hair, using keyboards or mobile/cell phones with the affected hand, and addresses the emotional stress from shoulder pain. In this prospective study, the MSS, with 10 questions, was administered to 114 patients (age 57 ± 11.4 years; 67 women [59%]) with painful shoulder pathology (shoulder stiffness [n = 95], rotator cuff tear [n = 15], shoulder osteoarthritis [n = 3], and subacromial bursitis [n = 1]). The MSS and the Oxford Shoulder Score (OSS) were administered to 114 patients at baseline and 40 of the 114 patients after an intervention (cuff repair, shoulder steroid injection, or shoulder replacement) by an independent research assistant. To establish the validity of MSS, we evaluated the construct validity, internal consistency, reliability, and sensitivity to change. We also tested the MSS in 30 healthy volunteers without any shoulder pathology.

The MSS showed a strong positive correlation with the OSS, as indicated by a Pearson correlation coefficient of 0.86 (P < .0001). The MSS had a strong internal consistency, which was indicated by a Cronbach alpha value of 0.839. Large effect sizes were observed for changes in MSS and OSS as indicated by Cohen's d (1.68 for MSS and 1.69 for OSS) and the standardized response mean (1.37 for MSS and 1.24 for OSS). The evaluation of MSS in 30 asymptomatic age-matched individuals yielded a score of 30 of a maximum of 30 in each of the 30 individuals.

MSS is a newly validated PROM to evaluate shoulder function in cases of shoulder disability and shoulder pain. It is short (10 questions), easily accessible (no license needed), has good internal consistency, is as reliable as the OSS, and has a good ability to detect a change in clinical status.