Williams Brendan A, Michel Ralph, LaChaud Gregory Y, Weltsch Daniel, Farmer Kevin W, King Joseph
Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, USA.
Anesthesiology, University of Florida, Gainesville, USA.
Cureus. 2020 Mar 5;12(3):e7189. doi: 10.7759/cureus.7189.
Introduction Superior labrum anterior to posterior (SLAP) tears are injuries of the shoulder's glenoid labrum involving biceps tendon insertion. We describe the scope of outcome measures used in the SLAP tear literature over the last decade and evaluate whether objective study metrics relate to level of evidence (LOE) and journal rank. Methods A comprehensive review of the literature was performed to identify all articles on the outcomes of the treatment of patients with SLAP tears published over the period of a decade (2007-2016). Studies were reviewed for LOE, SCImago Scientific Journal Ranking (SJR), study characteristics, and patient demographics. The utilization frequencies of outcome measures were recorded. Outcome measures were categorized as clinician-measured outcomes (CMOs), outcome scores/patient-reported outcomes (PROs), or other reported outcomes (OROs). Univariate analyses compared demographics and outcome-measure utilization among studies grouped by LOE (high: I/II vs. low: III/IV) and SJR (high: >2 vs. low: <2). Results The literature review identified 86 studies meeting inclusion criteria from an initial search of 582 articles. The mean study SJR was 2.02 and 0.85 +/- 0.79 CMOs were included. Twenty different outcome scores were utilized in the reviewed literature with a mean of 2.66 +/- 1.61 PROs/study. The most common outcome scores were ASES score, pain Visual Analog Scale (VAS), and constant score. High SJR studies had longer follow-up (p=0.036). High LOE studies utilized more CMOs (p=0.008) and more commonly included physical exam findings (p=0.0015). Revision surgery rate was less commonly reported in high LOE studies (p=0.036). None of the other outcome measures studied were associated with high study LOE or SJR. Conclusions Considerable variability exists in outcome-measure utilization within the recent SLAP tear literature. ASES score, pain VAS, and constant score are the most commonly reported PROs. CMOs and OROs are infrequently reported. There is little objectivity distinguishing higher and lower quality studies based on the proxy metrics used. Future SLAP tear research should focus on improving the consistency of outcome-measure reporting to enable more meaningful cross-study comparisons.
引言 上盂唇从前到后的（SLAP）撕裂是涉及肱二头肌肌腱附着处的肩关节盂唇损伤。我们描述了过去十年SLAP撕裂文献中使用的结果测量范围，并评估客观研究指标是否与证据水平（LOE）和期刊排名相关。方法 进行了全面的文献综述，以识别在十年期间（2007 - 2016年）发表的关于SLAP撕裂患者治疗结果的所有文章。对研究进行了证据水平、Scimago科学期刊排名（SJR）、研究特征和患者人口统计学方面的审查。记录了结果测量的使用频率。结果测量被分类为临床医生测量的结果（CMO）、结果评分/患者报告的结果（PRO）或其他报告的结果（ORO）。单因素分析比较了按证据水平（高：I/II与低：III/IV）和SJR（高：>2与低：<2）分组的研究之间的人口统计学和结果测量使用情况。结果 文献综述从对582篇文章的初步搜索中确定了86项符合纳入标准的研究。研究的平均SJR为2.02，纳入了0.85±0.79项CMO。在综述文献中使用了20种不同的结果评分，每项研究平均有2.66±1.61项PRO。最常见的结果评分是美国肩肘外科医师协会（ASES）评分、疼痛视觉模拟量表（VAS）和Constant评分。高SJR的研究随访时间更长（p = 0.036）。高证据水平的研究使用了更多的CMO（p = 0.008），并且更常包括体格检查结果（p = 0.0015）。高证据水平的研究中较少报告翻修手术率（p = 0.036）。所研究的其他结果测量均与高研究证据水平或SJR无关。结论 在最近的SLAP撕裂文献中，结果测量的使用存在相当大的差异。ASES评分、疼痛VAS和Constant评分是报告最常见的PRO。CMO和ORO很少被报告。基于所使用的替代指标，区分高质量和低质量研究几乎没有客观性。未来SLAP撕裂研究应专注于提高结果测量报告的一致性，以便能够进行更有意义的跨研究比较。
