Document Detail

Specificity and responsiveness of patient-reported and clinician-rated outcome measures in the context of elbow surgery, comparing patients with and without rheumatoid arthritis.
MedLine Citation:
PMID:  22951055     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To examine and contrast the ability of patient-reported and clinician-rated measures, reflecting different levels of specificity, to detect differences in outcomes between patients with and without rheumatoid arthritis (RA), at 6 months following elbow surgery.
METHODS: One hundred and four consecutive patients/elbows self-completed the Oxford Elbow Score (OES), Disabilities of the Arm, Shoulder and Hand (DASH) and SF-36 general health questionnaires prior to elbow surgery. A surgeon assessed the standard Mayo Elbow Performance Score (MEPS) and recorded patients' diagnoses. Assessments were repeated 6 months following surgery in an outpatient clinic. Patients also completed pain "transition" and global satisfaction items. Patients who did not attend completed their assessment by post.
RESULTS: Twenty-three (22%) patients had RA. These patients were more likely than other patients to have bilateral elbow problems and to have total elbow replacement (85.7% versus 10.5% P<0.001). Patients with RA had more severe preoperative elbow-specific scores, and experienced a large and significantly greater amount of change in elbow function, as measured by the OES function (P=0.002) and pain scales (P=0.013). The surgeon-assessed elbow-specific MEPS score also detected a large and significant difference between the two groups (P<0.001). However, these differences were not detected by the upper limb specific DASH, by any SF-36 general health dimensions, or by transition or satisfaction items.
CONCLUSIONS: The OES performed well in assessing surgical outcomes in patients with RA. Neither the upper limb specific DASH nor the SF-36 is specific or responsive enough to warrant its exclusive use as an outcome measure for elbow surgery.
LEVEL OF EVIDENCE: Level II (prospective non-randomised study).
J Dawson; H Doll; I Boller; R Fitzpatrick; C Little; J Rees; A Carr
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-08-27
Journal Detail:
Title:  Orthopaedics & traumatology, surgery & research : OTSR     Volume:  98     ISSN:  1877-0568     ISO Abbreviation:  Orthop Traumatol Surg Res     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-05     Completed Date:  2013-04-16     Revised Date:  2013-10-31    
Medline Journal Info:
Nlm Unique ID:  101494830     Medline TA:  Orthop Traumatol Surg Res     Country:  France    
Other Details:
Languages:  eng     Pagination:  652-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Department of Public Health, University of Oxford, Old Road Campus, Oxford OX3 7LF, United Kingdom.
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MeSH Terms
Aged, 80 and over
Arthritis, Rheumatoid / physiopathology,  surgery*
Arthroplasty, Replacement, Elbow*
Elbow Joint / physiopathology,  surgery*
Follow-Up Studies
Middle Aged
Pain Measurement / methods*
Patient Satisfaction*
Prospective Studies
Reproducibility of Results
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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