Abstract
QuestionsIs it possible to replace the Shoulder Pain and Disability Index (SPADI) with a single substitute question for people with shoulder pain, when measuring disability and how well does this substitute question perform as a predictor for recovery.DesignA prospective cohort study.ParticipantsA total of 356 patients with shoulder pain in primary care.AnalysesConvergent, divergent, and “known” groups validity were assessed by using hypotheses testing. Responsiveness was assessed using the Receiver Operating Curve and hypothesis testing. In addition, we performed multivariate regression to assess if the substitute question showed similar properties as the SPADI and if it affected the model itself, using recovery as an outcome.ResultsThe Spearman correlation coefficient between the total SPADI score and the substitute question was high, and moderate with the Shoulder Disability Questionnaire. The correlation between the substitute question and the EQ-5D-3L was low and the responsiveness was acceptable. The substitute question did not significantly contribute to both prognostic prediction models as opposed to the SPADI. Regardless all models showed poor to fair discrimination.ConclusionThe single question is a reasonable substitute for the SPADI and can be used as a screening instrument for shoulder disability in primary clinical practice. It has slightly poorer predictive power and should therefore not be used for prognosis.
Highlights
Activity limitations are one of the most important health consequences for patients with shoulder pain [1]
Both the Shoulder Pain and Disability Index (SPADI) as the Shoulder Disability Questionnaire (SDQ) are patient-reported outcome measures (PROMs) focusing on activity limitations
The most common reason for not using PROMs is that it is too time consuming for patients to complete (43%) and for clinicians to analyze, calculate, and score (30%); several PROMs are too difficult for patients to complete independently (29.1%) [8]
Summary
Activity limitations are one of the most important health consequences for patients with shoulder pain [1]. Shoulder pain presents an economic burden on society due to costs of sick leave and health care and impacts patient’s quality of life [3]. Health-related patient-reported outcome measures (PROMs) that assess perceived activity limitations are useful in terms of assessing the physical impairment in patients with shoulder pain [1, 4]. Both the Shoulder Pain and Disability Index (SPADI) as the Shoulder Disability Questionnaire (SDQ) are PROMs focusing on activity limitations. Several (systematic) reviews have encouraged the use of the SPADI in both clinical and research settings [5,6,7]
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