Mass General Brigham Sports Medicine, Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts, USA.
Investigation performed at the University of Kentucky, Lexington, Kentucky, USA.
Am J Sports Med. 2023 Sep;51(11):2850-2857. doi: 10.1177/03635465231188975. Epub 2023 Aug 16.
Patient-reported outcome measures (PROMs) have transitioned from primarily being used as research instruments to becoming increasingly used in the clinical setting to assess recovery and inform shared decision-making. However, there is a need to develop validated short-form PROM instruments to decrease patient burden and ease incorporation into clinical practice.
To assess the validity and responsiveness of a shortened version of the Western Ontario Shoulder Instability Index (Short-WOSI) when compared with the full WOSI and other shoulder-related PROM instruments.
Cohort study (diagnosis); Level of evidence, 2.
This study was a secondary analysis of data collected as part of an institutional review board-approved, multicenter cohort of 1160 patients undergoing surgical stabilization for shoulder instability. The following PROMs were captured preoperatively and 2 years after surgery: WOSI, American Shoulder and Elbow Surgeons (ASES) score, the Single Assessment Numeric Evaluation (SANE), and 36-Item Health Survey (RAND-36). The cohort was split into 2 data sets: a training set to be used in the development of the Short-WOSI (n = 580) and a test set to be used to assess the validity and responsiveness of the Short-WOSI relative to the full WOSI, ASES, SANE, and RAND-36.
The Short-WOSI demonstrated excellent internal consistency before surgery (Cronbach α = .83) and excellent internal consistency at the 2-year follow-up (Cronbach α = .93). The baseline, 2-year, and pre- to postoperative changes in Short-WOSI and WOSI were closely correlated ( > 0.90), with both demonstrating large effect sizes (Short-WOSI = 1.92, WOSI = 1.81). Neither the Short-WOSI nor the WOSI correlated well with the other PROM instruments before ( = 0.21-0.33) or after ( = 0.25-0.38) surgery. The Short-WOSI, WOSI, and SANE scores were more responsive than ASES and RAND-36 scores.
The 7-item Short-WOSI demonstrated excellent internal consistency and a lack of floor or ceiling effects. The Short-WOSI demonstrated excellent cross-sectional and longitudinal construct validity and was similarly responsive over time as the full WOSI. Neither the Short-WOSI nor WOSI correlated with more general shoulder PROMs, underscoring the advantage of using instability-specific instruments for this population.
患者报告的结局测量（PROMs）已经从主要作为研究工具转变为越来越多地在临床环境中使用，以评估恢复情况并为共同决策提供信息。然而，需要开发经过验证的简短 PROM 工具，以减轻患者负担并更轻松地将其纳入临床实践。
与完整的 WOSI 和其他肩部相关 PROM 工具相比，评估缩短版 Western Ontario 肩部不稳定指数（Short-WOSI）的有效性和响应能力。
队列研究（诊断）；证据水平，2 级。
本研究是对机构审查委员会批准的多中心队列研究中 1160 例接受肩部不稳定手术稳定的患者数据的二次分析。在术前和术后 2 年采集以下 PROM：WOSI、美国肩肘外科医师协会（ASES）评分、单一评估数字评估（SANE）和 36 项健康调查（RAND-36）。该队列分为 2 个数据集：用于开发 Short-WOSI 的训练集（n = 580）和用于评估 Short-WOSI 相对于完整的 WOSI、ASES、SANE 和 RAND-36 的有效性和响应能力的测试集。
Short-WOSI 在术前表现出极好的内部一致性（Cronbach α =.83），在 2 年随访时表现出极好的内部一致性（Cronbach α =.93）。Short-WOSI 和 WOSI 的基线、2 年和术前到术后的变化密切相关（> 0.90），两者均显示出较大的效应量（Short-WOSI = 1.92，WOSI = 1.81）。Short-WOSI 和 WOSI 在术前（= 0.21-0.33）或术后（= 0.25-0.38）均与其他 PROM 仪器相关性差。Short-WOSI、WOSI 和 SANE 评分比 ASES 和 RAND-36 评分更具响应性。
7 项 Short-WOSI 表现出极好的内部一致性，且无地板或天花板效应。Short-WOSI 表现出极好的横断面和纵向结构有效性，并且随着时间的推移与完整的 WOSI 一样具有响应能力。Short-WOSI 和 WOSI 均与更广泛的肩部 PROM 无相关性，这突出了在该人群中使用特定于不稳定的仪器的优势。
