Reliability of a novel, web-based, shoulder-specific, patient-reported outcome instrument

Abstract

Background: Paper versions of patient-reported outcomes instruments frequently are used in clinical settings, but the use of multiple or time intensive instruments may reduce response rate because of responder burden. Methods: Using questions from eight commonly used existing shoulder-specific patient-reported outcomes instruments, a single, condensed, web-based instrument was created. Existing instruments include 108 questions and the condensed questionnaire has 68 or fewer questions. Sixty consecutive patients within a single surgeon's academic shoulder and elbow practice completed a paper version of the Disabilities of the Arm, Shoulder, and Hand (DASH) and the entire web-based instrument before and after an office visit. Patients were randomized to which instrument was completed before their visit and completed the other instrument after the visit. Results: Fifty-five patients completed both surveys. The mean score for the paper version of the DASH was 41.7 (SEM ±3.5, 95% CI: 34.6-48.8) and the mean for the web-based extracted score was 41.3 (SEM ±3.4, 95% CI: 34.4-48.1). Comparing the paper version with the web-based version of the DASH, the mean difference in scores was found to be −0.42 (SEM 1.0, 95% CI: −2.4-1.6, range −25.0-16.7). Conclusions: The web-based shoulder specific outcomes instrument used in this study was able to generate a DASH score that was statistically similar to the traditional paper-based version of the DASH.