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CHOOSING A SELF-ADMINISTERED SHOULDER SCORING SYSTEM FOR USE OVER A RANGE OF SHOULDER PROBLEMS: A COMPARATIVE STUDY OF 3 SCORING SYSTEMS



Abstract

The purpose of the study was to compare three shoulder scoring systems with the aim of assessing their ability to identify disability over a spectrum of disease within a routine shoulder practice.

Considering our aims three systems were chosen for investigation; General Oxford Shoulder Questionnaire (GOSQ), Simple Shoulder Test Questionnaire (SST) and Hospital for Special Surgery System for Assessing Shoulder Function (HSS). Each was completed by 108 consecutive patients referred to our shoulder clinic, representing a spectrum of disease. These were compared with a pain and function score derived from the UK SF-36 Health Score. A subset of 27 patients repeated the questionnaires twenty four hours later to test repeatability of the scores. Agreement was calculated using Bland and Altman’s statistical method for assessing agreement between two methods of clinical measurement. This analysis was done both on the group as a whole and divided into five subgroups by diagnosis: instability (subgoup1), cuff tears and impingement (2), adhesive capsulitis (3), arthritis (4) and miscellaneous (5).

Reproducibility as a standard deviation (SD) of the difference between the scores after 24 hours: HSS 9.9, GOSQ 8.8, SST, 15.5 and SF-36 11.1.

Using the Bland and Altman method for assessing agreement, the scores both for repeatability and in comparison with the SF-36 are disappointing. It would appear that out of the three scores tested the HSS gives the most consistent results over a range of shoulder problems.

The abstracts were prepared by Mr Roger Emery. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN