Abstract
The validated, patient-reported Oxford shoulder score (OSS) was introduced around 10 years ago, primarily for the assessment of outcomes of shoulder surgery (excluding shoulder stabilisation) in randomised trials. Its uptake has steadily increased in a number of countries and its use has also been extended. Recently a number of issues have been raised in relation to other related patient-reported outcome measures which were devised around the same time as the OSS. This included recommendations to change the scoring system. This paper reviews issues concerning patient-reported outcome measures that apply to the OSS and makes some recommendations (including changes to the scoring system) as to how it should be used.
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Notes
Although one series of analyses revealed patient-reported outcome measures (OSS and SF-36) to be more stable than the Constant–Murley assessment, based on comparisons with ratings on satisfaction and transition items [6].
This secondary data analysis was conducted on anonymous data which had been retained from the original study [1].
References
Dawson J, Fitzpatrick R, Carr A (1996) Questionnaire on the perceptions of patients about shoulder surgery. J Bone Joint Surg (Br) 78:593–600
Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop (214):160–164
Lippitt SB, Harryman DT, Matsen FA (1993) A practical tool for evaluating function: the simple shoulder test. The shoulder: a balance of mobility and stability. American Academy of Orthopaedic Surgeons, Rosemont, pp 501–518
Dawson J, Fitzpatrick R, Carr A (1999) The assessment of shoulder instability: the development and validation of a questionnaire. J Bone Joint Surg (Br) 81-B:420–426
Pynsent P, Fairbank JTC, Carr A (1993) Outcome measures in orthopaedics. 1st edn. Butterworth-Heinemann, Oxford
Dawson J, Hill G, Fitzpatrick R, Carr A (2002) Comparison of clinical and patient-based measures to assess medium-term outcomes following shoulder surgery for disorders of the rotator cuff. Arthritis Rheum 47(5):513–9
Cloke DJ, Lynn SE, Watson H, Steen IN, Purdy S, Williams JR (2005) A comparison of functional, patient-based scores in subacromial im**ement. J Shoulder Elbow Surg 14(4):380–384
Rosenberg N, Soudry M (2006) Shoulder impairment following treatment of diaphysial fractures of humerus by functional brace. Arch Orthop Trauma Surg 126:437–440
Flinkkila T, Ristiniemi J, Lakovaara M, Hyvonen P, Leppilahti J (2006) Hook-plate fixation of unstable lateral clavicle fractures. Acta Orth 77(4):644–649
Huber W, Hofstaetter JG, Hanslik-Schnabel B, Posch M, Wurnig C (2004) The German version of the Oxford shoulder score—cross-cultural adaptation and validation. Arch Orthop Trauma Surg 124(8):531–536
Carr AJ, Fitzpatrick R, Gray A, Dawson J, Norrie J, Campbell M, Ramsay C, Rees J, Moser J (2007) United Kingdom Rotator Cuff Study (UKUFF trial) 01/05/2007–30/04/2012. Web-site: https://viis.abdn.ac.uk/HSRU/UKUFF/Site/Public/Default.aspx. HTA reference 05/47/02. Funded by the Department of Health
New Zealand National Joint Registry (2007) Canterbury District Health Board, New Zealand. http://www.cdhb.govt.nz/NJR/
Dawson J, Fitzpatrick R, Carr A, Murray D (1996) Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg (Br) 78:185–190
Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg (Br) 80(1):63–69
Murray DW, Fitzpatrick R, Rogers K, Pandit H, Beard DJ, Carr AJ, Dawson J (2007) The use of the Oxford hip and knee scores. J Bone Joint Surg (Br) 89-B:1010–1014
Unit of Health-Care Epidemiology (2007) See Oxford Orthopaedic scores link on patient-reported health instruments. University of Oxford, web-site http://phi.uhce.ox.ac.uk/
Dawson J, Hill G, Fitzpatrick R, Carr A (2001) The benefits of using patient-based methods of assessment: medium term results of an observational study of shoulder surgery. J Bone Joint Surg (Br) 83(6):877–882
Weale AE, Halabi OA, Jones PW, While SH (2001) Perceptions of outcomes after unicompartmental and total knee replacements. Clin Orthop Rel Res 382:143–153
Kirkley A, Griffin S, Alvarez C (2003) The development and evaluation of a disease-specific quality of life measurement tool for rotator cuff disease: the Western Ontario rotator cuff index (WORC). Clin J Sport Med 13:84–92
Kirkley A, Griffin S, Dainty K (2003) Shoulder systems for the functional assessment of the shoulder. Arthroscopy 19(10):1109–1120
Amstutz HC, Sew Hoy AL, Clarke IC (1981) UCLA anatomic total shoulder arthroplasty. Clin Orthop 155:7–20
Roach KE, Budiman ME, Songsiridej N, Lertratanakul Y (1991) Development of a shoulder pain and disability index. Arthritis Care Res 4(4):143–149
Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) (corrected). The Upper Extremity Collaborative Group (UECG) [Published erratum appears in Am J Ind Med (1996) 30(3):372]. Am J Ind Med 29(6):602–608
L’Insalata JC, Warren RF, Cohen SB, Altchek DW, Peterson MG (1997) A self-administered questionnaire for assessment of symptoms and function of the shoulder. J Bone Joint Surg (Am) 79(5):738–748
Boehm D, Wollmerstedt N, Doesch M, Handwerker M, Mehling E, Gohlke F (2004) Development of a questionnaire based on the Constant–Murley score for self-evaluation of shoulder function by patients. Unfallchirurg 107(5):397–402
Wright JG, Rudicel S, Feinstein AR (1994) Ask patients what they want. Evaluation of individual complaints before total hip replacement. J Bone Joint Surg (Br) 76(2):229–234
Schneider W, Knahr K (2001) Surgery for Hallux Valgus. The expectations of patients and surgeons. Int Orthop 25:382–385
Beaton DE (2000) Understanding the relevance of measured change through studies of responsiveness. Spine 25(24):3192–3199
Guyatt G, Walter S, Norman G (1987) Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis 40(2):171–178
Ware-JE J, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483
Jenkinson C, Stewart-Brown S, Petersen S, Paice C (1999) Evaluation of the SF-36 version II in the United Kingdom. J Epidemiol Community Health 53:46–50
The Euroqol Group (1990) Euroqol—a new facility for the measurement of health-related quality of life. Health Policy 16:199–208
Lim JT, Luscombe KL, Jones PW, White SH (2006) The effect of preoperative symptom severity on functional outcome of total knee replacement–patients with the lowest preoperative scores achieve the lowest marks. Knee 13(3):216–219
Hajat S, Fitzpatrick R, Morris R, Reeves B, Rigge M, Williams O, Murray D, Gregg P (2002) Does waiting for total hip replacement matter? Prospective cohort study. J Health Serv Res and Policy 7(1):19–25
Vickers AJ, Altman DG (2001) Analysing controlled trials with baseline and follow-up measurements. BMJ 323:1123–1124
Porter P, Venkateswaran B, Stephenson H, Wray CC (2002) The influence of age on outcome after operation for the carpel tunnel syndrome. J Bone Joint Surg (Br) 84-B(5):688–691
Bremner-Smith AT, Ewings P, Weale AE (2004) Knee scores in a ‘Normal’ elderly population. Knee 11(4):279–282
Jenkinson C, Heffernan C, Doll H, Fitzpatrick R (2006) The Parkinson’s Disease questionnaire: evidence for a method of imputing missing data. Age Ageing 35:497–502
Bland JM, Altman DG (1996) Transforming data. BMJ 312(7033):770
Jaeschke R, Singer J, Guyatt GH (1989) Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials 10(4):407–415
Wyrwich KW, Tierney WM, Wolinsky FD (1999) Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life. J Clin Epidemiol 52(9):861–873
Fayers PM, Machin D (2000) Quality of life—assessment, analysis and interpretation. Wiley, Chichester
Norman GR, Sloan JA, Wyrwich KW (2003) Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 41:582–592
Acknowledgments
Regarding the secondary data analysis conducted to inform the table in this paper. The original study that generated these data was conducted in the early 1990s and we wish to acknowledge receipt of funding for that study by grant from Oxford Regional Health Authority (Audit). These data were retained in an anonymised form. The study complied with the laws of the UK, which at that time, did not require informed consent from patients for a purely observational study, as completion of a questionnaire was accepted as implicit consent.
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None of the authors have any conflict of interest in relation to this paper.
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Dawson, J., Rogers, K., Fitzpatrick, R. et al. The Oxford shoulder score revisited. Arch Orthop Trauma Surg 129, 119–123 (2009). https://doi.org/10.1007/s00402-007-0549-7
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DOI: https://doi.org/10.1007/s00402-007-0549-7