Edmonds Eric W, Bastrom Tracey P, Roocroft Joanna H, Calandra-Young Valerie A, Pennock Andrew T
Rady Children's Hospital, San Diego, California, USA.
University of California-San Diego, San Diego, California, USA.
Orthop J Sports Med. 2017 Mar 29;5(3):2325967117698466. doi: 10.1177/2325967117698466. eCollection 2017 Mar.
Health-related quality of life tools for shoulder pathology in adults have been developed, such as the Disabilities of the Arm, Shoulder, and Hand (DASH) or QuickDASH. However, some content is not applicable to or readily grasped by a younger population.
To evaluate the psychometric properties of a new 13-item pediatric/adolescent shoulder survey (PASS).
Cohort study (diagnosis); Level of evidence, 2.
An initial development cohort of children was given the PASS, QuickDASH, and single assessment numeric evaluation (SANE) in a prospective fashion. Internal reliability and concurrent validity were evaluated. Subsequent to this, the PASS, along with the QuickDASH, was incorporated into routine clinical evaluation of shoulder injuries. The secondary cohort was established via a retrospective review of patients (age <18 years) evaluated in our sports clinics for shoulder complaints. Discriminant validity and floor/ceiling effects were evaluated. A subset of patients with scores available both pre- and within 6 months postoperatively was analyzed to assess responsiveness to treatment.
Overall internal reliability of the shoulder survey was good in the development cohort of 127 patients, with Cronbach α = 0.86. Total score averaged 59.7% ± 17.9% in this cohort (range, 18.75%-100%). Significant correlations between all surveys were observed ( = 0.51-0.79, < .05). A total of 127 surveys were available for the secondary cohort. The QuickDASH demonstrated significant differences between sexes with regard to scores ( < .05). Both tools were able to discriminate between patients with acute injuries and diminished clinical examinations ( < .05). A significant correlation was observed between duration of symptoms and scores on the PASS. The subset of 25 patients with pre- and postoperative data showed significant change in total score and the symptoms/limitations domain of the PASS, with significant correlation with length of time since surgery.
This 13-question pediatric/adolescent-focused shoulder survey shows excellent psychometric properties, good discriminant ability, and early evidence of responsiveness to change, especially when compared with an adult-formatted questionnaire.
已开发出用于评估成人肩部疾病的健康相关生活质量工具，如上肢、肩部和手部功能障碍量表（DASH）或简化上肢、肩部和手部功能障碍量表（QuickDASH）。然而，有些内容并不适用于年轻人群体，或者他们难以理解。
评估一种新的包含13个条目的儿童/青少年肩部调查问卷（PASS）的心理测量特性。
队列研究（诊断）；证据等级，2级。
对一组初始的儿童队列进行前瞻性研究，让他们完成PASS、QuickDASH和单项评估数值评定法（SANE）。评估内部信度和同时效度。在此之后，将PASS与QuickDASH纳入肩部损伤的常规临床评估中。通过回顾性分析在我们运动诊所因肩部问题接受评估的患者（年龄<18岁）建立次级队列。评估区分效度和地板效应/天花板效应。分析一组术前和术后6个月内都有评分的患者子集，以评估对治疗的反应性。
在127例患者的开发队列中，肩部调查问卷的总体内部信度良好，Cronbach α系数为0.86。该队列中的总分平均为59.7%±17.9%（范围为18.75%-100%）。观察到所有调查问卷之间存在显著相关性（r = 0.51-0.79，P <.05）。次级队列共有127份调查问卷。QuickDASH在得分方面显示出显著的性别差异（P <.05）。两种工具都能够区分急性损伤患者和临床检查结果不佳的患者（P <.05）。观察到症状持续时间与PASS得分之间存在显著相关性。25例有术前和术后数据的患者子集显示，PASS的总分以及症状/功能受限领域有显著变化，且与术后时间长度有显著相关性。
这种以儿童/青少年为重点的包含13个问题的肩部调查问卷显示出优异的心理测量特性、良好的区分能力以及对变化的反应性的早期证据，尤其是与成人格式的问卷相比时。
