Psychometric properties of patient-reported outcome questionnaires for patients with musculoskeletal disorders of the shoulder
To evaluate the psychometric properties of self-administered patient-reported outcome (PRO) questionnaires which were used in non-surgical homogeneous populations with musculoskeletal shoulder disorders.
The included studies were identified using eligibility criteria. The methodological quality of each article was assessed using the COSMIN checklist. The psychometric properties of original versions and translated versions of PROs were also assessed.
Twenty articles were included. Two musculoskeletal shoulder disorders were identified that met the selection criteria: rotator cuff disease and glenohumeral instability. A total of 11 PROs were identified. In general, the methodological quality of the included studies is fair or poor. The Western Ontario Rotator Cuff Index (WORC) and the Shoulder Pain and Disability Index (SPADI) are the most frequently evaluated PROs for patients with rotator cuff disease, and their psychometric properties seem to vary according to what language that they are in. For glenohumeral instability, the Western Ontario Shoulder Instability Index (WOSI) and the Oxford Instability Shoulder Score (OISS) are the most frequently evaluated PROs, and their psychometric properties seem to be adequate.
Using for rotator cuff disease is advised, for Norwegian users, the SPADI, WORC, Oxford Shoulder Score, and disabilities of the arm, shoulder and hand. Dutch and Persian users could use the WORC. For Greek speakers, the SPADI is recommended. Turkish users could use the rotator cuff quality-of-life measure. For glenohumeral instability, Dutch and Norwegian speakers could use the WOSI and the OISS. Italian, Japanese, and Turkish users could use the WOSI. For English users, the OISS and the Shoulder Rating Questionnaire are recommended.
Level of evidence
KeywordsPsychometric Shoulder Patient-reported outcome measures Surveys and questionnaires Shoulder pain
The authors acknowledge Xuanyan Xu who is the marketing manager for Embase at Elsevier, for her help with free trial access to Embase database.
ES and BU contributed to the study design. ES, GE, and BU contributed to the development of the search strategy, and performed of the searching. ES and GE selected studies, pooled the data, and performed the data synthesis. All authors contributed to the data interpretation. ES was the principal writer of the manuscript. All authors contributed to the writing of the final version.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study was approved by Noninvasive Research Ethics Board of Dokuz Eylül University School of Medicine (protocol no: 3180-GOA, decision number: 2017/05-11) and was pre-registered in PROSPERO (CRD42017058527), in March 2017.
All data are available in the submitted manuscript or as appendix.
- 8.Thoomes-de Graaf M, Scholten-Peeters GGM, Schellingerhout JM, Bourne AM, Buchbinder R, Koehorst M, Terwee CB, Verhagen AP (2016) Evaluation of measurement properties of self-administered PROMs aimed at patients with non-specific shoulder pain and”activity limitations”: a systematic review. Qual Life Res 25:2141–2160CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Terwee CB, de Vet H, Prinsen C, Mokkink LB (2011) Protocol for systematic reviews of measurement properties. http://www.cosmin.nl. Accessed 21 May 2017
- 18.Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HCW (2010) The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol 63:737–745CrossRefPubMedGoogle Scholar
- 21.Van Tulder M, Furlan A, Bombardier C, Bouter L, Editorial Board of the Cochrane Collaboration Back Review Group (2003) Updated method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group. Spine (Phila Pa 1976) 28:1290–1299Google Scholar
- 26.Lippitt SB, Harryman DT, Matsen FA (1993) A practical tool for evaluating function: the simple shoulder test. In: Matsen FA III, Fu FH, Hawkins RJ (eds) The shoulder: a balance of mobility and stability. American Academy of Orthopedic Surgery, Rosemont, pp 501–518Google Scholar
- 33.Altman D (1991) Practical statistics for medical research. Chapman and Hall, LondonGoogle Scholar
- 40.Vrouva S, Batistaki C, Koutsioumpa E, Kostopoulos D, Stamoulis E, Kostopanagiotou G (2016) The Greek version of Shoulder Pain and Disability Index (SPADI): translation, cultural adaptation, and validation in patients with rotator cuff tear. J Orthop Traumatol 17:315–326CrossRefPubMedPubMedCentralGoogle Scholar
- 42.Mehta SP, Tiruttani R, Kaur MN, MacDermid J, Karim R (2015) Psychometric properties of the hindi version of the disabilities of arm, shoulder, and hand: a pilot study. Rehabil Res Pract 2015:482378Google Scholar
- 47.Skare Ø, Liavaag S, Reikerås O, Mowinckel P, Brox JI (2013) Evaluation of Oxford instability shoulder score, Western Ontario shoulder instability index and Euroqol in patients with SLAP (superior labral anterior posterior) lesions or recurrent anterior dislocations of the shoulder. BMC Res Notes 6:273CrossRefPubMedPubMedCentralGoogle Scholar
- 50.Cacchio A, Paoloni M, Griffin SH, Rosa F, Properzi G, Padua L, Padua R, Carnelli F, Calvisi V, Santilli V (2012) Cross-cultural adaptation and measurement properties of an Italian version of the Western Ontario Shoulder Instability Index (WOSI). J Orthop Sports Phys Ther 42:559–567CrossRefPubMedGoogle Scholar
- 53.Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC (2012) The COSMIN checklist manual. http://www.cosmin.nl. Accessed 21 May 2017
- 55.St-Pierre C, Desmeules F, Dionne CE, Frémont P, MacDermid JC, Roy J-S (2015) Psychometric properties of self-reported questionnaires for the evaluation of symptoms and functional limitations in individuals with rotator cuff disorders: a systematic review. Disabil Rehabil 8288:1–20Google Scholar