Physiotherapists’ use and perspectives on the importance of patient-reported outcome measures for shoulder dysfunction

Abstract

Background: Many patient-reported outcome measures (PROs) for shoulder dysfunctions have acceptable psychometric properties. However, the large number of measures that are available present clinicians and researchers with dilemmas in PRO selection. This study set out to determine the perceived importance of PROs, the measures currently used by physiotherapists in clinical practice and research, and the psychometric criteria that are considered important in PRO selection. Methods: Delegates at the 2010 International Congress of Shoulder and Elbow Therapists were invited to participate in this cross-sectional observational study. Research Electronic Data Capture (REDCap) web-based tools were used to design an online questionnaire. IRB approval was gained prior to commencement of the study. Anonymised numerical survey data were tallied and frequency counts reported descriptively. Results: Participants submitted 101 completed questionnaires, which was an 84% response rate. One or more validated shoulder or upper extremity PROs were used by 91% of clinicians, and 94% of researchers. The use of PROs was considered to be ‘extremely’ or ‘very’ important by the majority of clinicians (76%), and researchers (98%). Most commonly used as a primary outcome by clinicians and researchers respectively were: the Disabilities of the Arm Shoulder Hand Questionnaire (DASH) (40%, 44%) and the Oxford Shoulder Scale (OSS) (36%, 22%); and as secondary outcomes: the DASH (33%, 28%); OSS (17%, 8%), the Shoulder Pain and Disability Index (SPADI) (8%, 18%); and the American Shoulder and Elbow Surgeons standardized assessment form (ASES) (8%, 13%). Psychometric properties and practicality aspects were deemed extremely or very important by 86–96% of participants. Conclusion: The majority of clinicians and researchers use a shoulder or upper extremity function or disability questionnaire. This indicates that PROs are considered important in clinical practice and research, and psychometric properties are critical in PRO selection. The DASH, OSS, SPADI and ASES are most commonly used by shoulder therapists in clinical practice and research studies. Implications: These findings can be used to aid the development of a consensus on a core set of PROs for shoulder dysfunctions for use by clinicians and researchers.