Basic ScienceIs the Simple Shoulder Test a valid outcome instrument for shoulder arthroplasty?
Section snippets
Study subjects
Patients in our practice undergoing shoulder arthroplasty between the dates of August 2010 and March 2014 were invited to participate in a prospective outcome study. Those patients with complete baseline characteristics and 2-year outcomes during the time period were included in this analysis. Patients completed the SST and the 36-Item Short Form Health Survey (SF-36) questionnaire preoperatively (within 30 days of surgery) and postoperatively at 2 years. A total of 522 patients were enrolled
Construct validity
Scores after shoulder arthroplasty were improved from a mean of 3.9 ± 2.8 preoperatively to 10.2 ± 2.3 postoperatively (P < .001). Both Cohen's d (2.29) and the SRM (2.05) were large. The effect size and SRM of the SST were larger than that of each SF-36 domain (Table II).
Content validity
The correlation between the SST and SF-36 was moderate for most of the physical domains, including physical function, role physical, and bodily pain (Table III). Correlation was slight or fair for the mental components of the
Discussion
The SST has been used as an outcome measure in many studies evaluating outcomes in patients treated for shoulder arthritis,8, 9, 15, 24, 34 but this instrument has not been rigorously validated for this specific population of patients. This study reports the construct validity, criterion validity, and responsiveness of the SST in a large series of patients undergoing shoulder arthroplasty.
Two prior studies have focused on some of the features of the SST in patients with shoulder arthritis,31, 37
Conclusion
This study of the psychometric properties of the SST combined with a systematic review of the literature indicates that this low-cost, brief, and convenient instrument provides a patient-reported measure that is valid in the measurement of shoulder arthroplasty outcomes.
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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This study was approved by the Institutional Review Board of the University of Washington: No. 38897.