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一项国际多中心队列研究,比较了 6 种肩部临床评分在无症状人群中的应用。

An international, multicenter cohort study comparing 6 shoulder clinical scores in an asymptomatic population.

机构信息

Discipline of Orthopaedics and Trauma, University of Adelaide, North Terrace, Adelaide, SA, Australia; Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.

Discipline of Orthopaedics and Trauma, University of Adelaide, North Terrace, Adelaide, SA, Australia.

出版信息

J Shoulder Elbow Surg. 2018 Feb;27(2):306-314. doi: 10.1016/j.jse.2017.08.016. Epub 2017 Dec 6.

Abstract

HYPOTHESIS

The study purpose was to assess 6 shoulder patient-reported outcome measure (PROM) values in asymptomatic, healthy, pathology-free individuals. We hypothesized that there would be no difference in PROM values in pathology-free individuals when considering sex, age, ethnicity, and geographical location.

METHODS

Electronic questionnaires were completed by 635 individuals (323 Australians and 312 Canadians) without dominant shoulder pathology for the American Shoulder and Elbow Surgeons (ASES) shoulder score; Constant-Murley Shoulder Score (CSS); Oxford Shoulder Score (OSS); University of California, Los Angeles (UCLA) shoulder score; Shoulder Pain and Disability Index (SPADI); and Stanmore Percentage of Normal Shoulder Assessment (SPONSA). Shoulder range of motion and strength were assessed.

RESULTS

No difference was identified between subjective-only and subjective-objective PROMs. Handedness and a current elbow or wrist problem were not associated with differences in PROM values. Poorer PROM values were associated with a history of an inactive shoulder problem and increasing age. Female participants tended to report similar or poorer PROM scores. No significant difference was found between ethnicities. Geographical location was associated with differences in the ASES shoulder score, UCLA shoulder score, and SPADI but not the CSS, SPONSA, and OSS.

CONCLUSIONS

Differences in sex, age, and geographical location will affect PROM shoulder scores in pathology-free individuals and should be taken into consideration when PROMs are being used to compare patient outcomes. This study has established normative values for the ASES shoulder score, CSS, OSS, UCLA shoulder score, SPADI, and SPONSA. Future studies assessing a pathologic patient cohort should perform comparisons against a sex- and age-matched control cohort, ideally sourced from the same geographical location.

摘要

假设

本研究旨在评估 6 项肩部患者报告结局测量(PROM)在无症状、健康、无病理学个体中的值。我们假设,在考虑无病理学个体的性别、年龄、种族和地理位置时,PROM 值不会存在差异。

方法

635 名(323 名澳大利亚人和 312 名加拿大人)无优势肩病理学的个体完成了美国肩肘外科医师协会(ASES)肩部评分、Constant-Murley 肩部评分(CSS)、牛津肩部评分(OSS)、加利福尼亚大学洛杉矶分校(UCLA)肩部评分、肩部疼痛和残疾指数(SPADI)以及斯坦福百分比正常肩部评估(SPONSA)的电子问卷。评估了肩部活动范围和力量。

结果

主观和主观客观 PROM 之间未发现差异。惯用手和当前肘部或手腕问题与 PROM 值的差异无关。较差的 PROM 值与既往不活跃的肩部问题和年龄增长有关。女性参与者倾向于报告相似或较差的 PROM 评分。种族之间未发现显著差异。地理位置与 ASES 肩部评分、UCLA 肩部评分和 SPADI 之间存在差异,但 CSS、SPONSA 和 OSS 无差异。

结论

性别、年龄和地理位置的差异会影响无病理学个体的 PROM 肩部评分,在使用 PROM 来比较患者结局时应考虑这些因素。本研究确立了 ASES 肩部评分、CSS、OSS、UCLA 肩部评分、SPADI 和 SPONSA 的正常值。未来评估病理性患者队列的研究应针对性别和年龄匹配的对照组进行比较,理想情况下该对照组来自相同的地理位置。

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