Ardebol Javier, Ghayyad Kassem, Hwang Simon, Pak Theresa, Menendez Mariano E, Denard Patrick J
Shoulder Surgery, Oregon Shoulder Institute, Medford, OR, USA.
JSES Rev Rep Tech. 2023 Jun 10;3(3):312-317. doi: 10.1016/j.xrrt.2023.05.008. eCollection 2023 Aug.
Different patient-reported outcome (PRO) tools are used in patients with arthroscopic rotator cuff repair (ARCR) which complicates outcome comparisons. The purpose of this systematic review was to compare PRO usage and baseline scores across world regions and countries in patients with ARCR of massive rotator cuff tears (MRCT).
A systematic review was performed on ARCR for MRCT. The search was conducted from September to November of 2022 using the MEDLINE database for articles published in the last 15 years. Thirty-seven articles were included after initial screening and full-text review. In each article, PRO usage, baseline scores, and country of origin were collected. PRO usage was reported in percentages and baseline scores were normalized for each region to facilitate comparisons. Normalization was performed using the PRO means from each article. These averages were converted to fractions using the worst and best possible scores. These were combined into a single numerical value, expressed as a decimal from 0 to 1, using the total sample size for each tool per region. Values closer to 0 represent worse functional outcomes.
Thirty-two percent (n = 12) of articles were from Asia, 43.2% (n = 16) from Europe, 5.4% (n = 2) from the Middle East, and 18.9% (n = 7) from North America. The most commonly reported PRO tools were American Shoulder and Elbow Surgeons (ASES) in 19 papers, Constant-Murley Score (CMS) in 26 papers, Visual Analog Scale for pain (VAS) in 19 papers, and University of California in Los Angeles (UCLA) in 11 papers. ASES was reported in 51% of articles with 63% being from Asia (n = 12) compared to 21% from North America (n = 4). CMS was reported in 70% of studies with 58% being from Europe. Upon normalization, the preoperative score ranged from 0.30 to 0.44. Europe (0.39), and North America (0.40) showed similar scores. The lowest and highest scores were seen in the Middle East (0.3) and Asia (0.44) respectively.
There is no standardized method to report outcomes in patients undergoing ARCR for MRCT. Great variation in usage exists in PROs which complicates data comparison between world regions. With normalization, baseline scores where similar among Asia, North America, and Europe, and lowest in the Middle East.
关节镜下肩袖修补术（ARCR）患者使用了不同的患者报告结局（PRO）工具，这使得结局比较变得复杂。本系统评价的目的是比较全球各地区和国家在巨大肩袖撕裂（MRCT）的ARCR患者中PRO的使用情况和基线评分。
对MRCT的ARCR进行系统评价。2022年9月至11月，使用MEDLINE数据库检索过去15年发表的文章。经过初步筛选和全文审查，纳入了37篇文章。在每篇文章中，收集了PRO的使用情况、基线评分和原产国。PRO的使用情况以百分比报告，每个地区的基线评分进行标准化以方便比较。标准化使用每篇文章中的PRO均值进行。这些平均值使用最差和最好可能得分转换为分数。使用每个工具在每个地区的总样本量将这些分数合并为一个单一数值，以0到1的小数表示。值越接近0表示功能结局越差。
32%（n = 12）的文章来自亚洲，43.2%（n = 16）来自欧洲，5.4%（n = 2）来自中东，18.9%（n = 7）来自北美。最常报告的PRO工具是19篇文章中的美国肩肘外科医师协会（ASES）评分、26篇文章中的Constant-Murley评分（CMS）、19篇文章中的疼痛视觉模拟量表（VAS）和11篇文章中的加利福尼亚大学洛杉矶分校（UCLA）评分。51%的文章报告了ASES评分，其中63%来自亚洲（n = 12），而北美为21%（n = 4）。70%的研究报告了CMS评分，其中58%来自欧洲。标准化后，术前评分范围为0.30至0.44。欧洲（0.39）和北美（0.40）的评分相似。中东（0.3）和亚洲（0.44）分别出现了最低和最高评分。
对于接受MRCT的ARCR患者，没有标准化的方法来报告结局。PRO的使用存在很大差异，这使得不同世界地区之间的数据比较变得复杂。经过标准化后，亚洲、北美和欧洲的基线评分相似，中东地区最低。
