Hsu Jason E, Russ Stacy M, Somerson Jeremy S, Tang Anna, Warme Winston J, Matsen Frederick A
Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA.
The University of Texas Medical Branch, Galveston, TX, USA.
J Shoulder Elbow Surg. 2017 Oct;26(10):1693-1700. doi: 10.1016/j.jse.2017.03.029. Epub 2017 Jun 7.
The Simple Shoulder Test (SST) is a brief, inexpensive, and widely used patient-reported outcome tool, but it has not been rigorously evaluated for patients having shoulder arthroplasty. The goal of this study was to rigorously evaluate the validity of the SST for outcome assessment in shoulder arthroplasty using a systematic review of the literature and an analysis of its properties in a series of 408 surgical cases.
SST scores, 36-Item Short Form Health Survey scores, and satisfaction scores were collected preoperatively and 2 years postoperatively. Responsiveness was assessed by comparing preoperative and 2-year postoperative scores. Criterion validity was determined by correlating the SST with the 36-Item Short Form Health Survey. Construct validity was tested through 5 clinical hypotheses regarding satisfaction, comorbidities, insurance status, previous failed surgery, and narcotic use.
Scores after arthroplasty improved from 3.9 ± 2.8 to 10.2 ± 2.3 (P < .001). The change in SST correlated strongly with patient satisfaction (P < .001). The SST had large Cohen's d effect sizes and standardized response means. Criterion validity was supported by significant differences between satisfied and unsatisfied patients, those with more severe and less severe comorbidities, those with workers' compensation or Medicaid and other types of insurance, those with and without previous failed shoulder surgery, and those taking and those not taking narcotic pain medication before surgery (P < .005).
These data combined with a systematic review of the literature demonstrate that the SST is a valid and responsive patient-reported outcome measure for assessing the outcomes of shoulder arthroplasty.
简单肩部测试（SST）是一种简短、廉价且广泛使用的患者报告结局工具，但尚未对接受肩关节置换术的患者进行严格评估。本研究的目的是通过对文献的系统回顾以及对408例手术病例的特性分析，严格评估SST在肩关节置换术结局评估中的有效性。
术前及术后2年收集SST评分、36项简明健康调查问卷评分和满意度评分。通过比较术前和术后2年的评分来评估反应性。通过将SST与36项简明健康调查问卷进行关联来确定效标效度。通过5个关于满意度、合并症、保险状况、既往手术失败和使用麻醉剂的临床假设来测试结构效度。
关节置换术后评分从3.9±2.8提高到10.2±2.3（P<.001）。SST的变化与患者满意度密切相关（P<.001）。SST具有较大的科恩d效应量和标准化反应均值。效标效度得到以下方面显著差异的支持：满意和不满意的患者、合并症严重程度不同的患者、有工伤赔偿或医疗补助及其他类型保险的患者、既往有或无肩部手术失败的患者，以及术前服用和未服用麻醉性止痛药的患者（P<.005）。
这些数据与文献的系统回顾相结合表明，SST是一种有效且具有反应性的患者报告结局指标，可用于评估肩关节置换术的结局。
