Reliability, validity, and responsiveness of a novel subscapularis outcome score: the Baltimore Orthopedic Subscapularis Score
Background: Available surveys that evaluate shoulder strength and pain often combine rotator cuff muscles making the test unable to differentiate subscapularis tears from other pathology including concomitant supraspinatus, infraspinatus tears. The purpose of this study was to validate a subscapular...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638322001736 |
| _version_ | 1811255585487716352 |
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| author | Max Hamaker, MD Blessing Enobun, MD, MPH Samir Kaveeshwar, MD S. Ashfaq Hasan, MD Brian Shiu, MD R. Frank Henn, III, MD Kelly Kilcoyne, MD Umasuthan Srikumaran, MD Gregory Gasbarro, MD Zachary R. Zimmer, MD Mohit N. Gilotra, MD, MS |
| author_facet | Max Hamaker, MD Blessing Enobun, MD, MPH Samir Kaveeshwar, MD S. Ashfaq Hasan, MD Brian Shiu, MD R. Frank Henn, III, MD Kelly Kilcoyne, MD Umasuthan Srikumaran, MD Gregory Gasbarro, MD Zachary R. Zimmer, MD Mohit N. Gilotra, MD, MS |
| author_sort | Max Hamaker, MD |
| collection | DOAJ |
| description | Background: Available surveys that evaluate shoulder strength and pain often combine rotator cuff muscles making the test unable to differentiate subscapularis tears from other pathology including concomitant supraspinatus, infraspinatus tears. The purpose of this study was to validate a subscapularis-specific shoulder survey (Baltimore Orthopedic Subscapularis Score) as a viable clinical outcome assessment through analysis of psychometric properties. Methods: A 5-question survey was given to a study population of 390 patients, 136 of whom had full thickness rotator cuff tears with a minimum score of 5 (better) and a maximum score of 25 (worse). Surveys were given during the initial consultation, preoperative visit, and postoperative visit. Content validity, construct validity, test-retest reliability, responsiveness to change, internal consistency, and minimal clinically important difference using distribution and anchor-based methods were determined for our subscapularis function survey. Results: A high correlation was reported on test-retest reliability (intraclass correlation coefficient = 0.89). An acceptable internal consistency was reported for all patients surveyed (Cronbach alpha = 0.91). Floor and ceiling effects for patients with rotator cuff pathology were minimized (1% for both). Patients with an isolated subscapularis tear scored worse than supraspinatus/infraspinatus tears and exhibited similar dysfunction as patients with a supraspinatus/infraspinatus/subscapularis tear. An acceptable construct validity was reported with subscapularis-involved tears demonstrating higher scores with significance (P < .05). There was excellent responsiveness to change with a standardized response mean of 1.51 and effect size of 1.27 (large > 0.8). The minimal clinically important difference using a distribution and anchor-based method was 4.1 and 4.6, respectively. Among patients with rotator cuff tears in this population, a score of 22 or higher predicts a subscapularis tear 75% of the time, in spite of its low overall prevalence. Conclusion: The subscapularis shoulder score demonstrated acceptable psychometric performance for outcomes assessment in patients with rotator cuff disease. This survey can be used as an effective clinical tool to assess subscapularis function. |
| first_indexed | 2024-04-12T17:27:07Z |
| format | Article |
| id | doaj.art-2e9c4267684b4e1ca7811da6a899e62d |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-04-12T17:27:07Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-2e9c4267684b4e1ca7811da6a899e62d2022-12-22T03:23:16ZengElsevierJSES International2666-63832022-11-0166957962Reliability, validity, and responsiveness of a novel subscapularis outcome score: the Baltimore Orthopedic Subscapularis ScoreMax Hamaker, MD0Blessing Enobun, MD, MPH1Samir Kaveeshwar, MD2S. Ashfaq Hasan, MD3Brian Shiu, MD4R. Frank Henn, III, MD5Kelly Kilcoyne, MD6Umasuthan Srikumaran, MD7Gregory Gasbarro, MD8Zachary R. Zimmer, MD9Mohit N. Gilotra, MD, MS10Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USADepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USADepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USADepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USADepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USADepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USADepartment of Orthopedics, Walter Reed National Military Medical Center, Bethesda, MD, USAJohns Hopkins Medicine, Baltimore, MD, USAOrthopaedic Specialty Hospital Mercy Medical Center, Baltimore, MD, USADepartment of Orthopaedic Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USADepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA; Corresponding author: Mohit N. Gilotra, MD, MS, Department of Orthopaedics, University of Maryland School of Medicine, 100 Penn St, Room 540D Baltimore, MD 21201, USA.Background: Available surveys that evaluate shoulder strength and pain often combine rotator cuff muscles making the test unable to differentiate subscapularis tears from other pathology including concomitant supraspinatus, infraspinatus tears. The purpose of this study was to validate a subscapularis-specific shoulder survey (Baltimore Orthopedic Subscapularis Score) as a viable clinical outcome assessment through analysis of psychometric properties. Methods: A 5-question survey was given to a study population of 390 patients, 136 of whom had full thickness rotator cuff tears with a minimum score of 5 (better) and a maximum score of 25 (worse). Surveys were given during the initial consultation, preoperative visit, and postoperative visit. Content validity, construct validity, test-retest reliability, responsiveness to change, internal consistency, and minimal clinically important difference using distribution and anchor-based methods were determined for our subscapularis function survey. Results: A high correlation was reported on test-retest reliability (intraclass correlation coefficient = 0.89). An acceptable internal consistency was reported for all patients surveyed (Cronbach alpha = 0.91). Floor and ceiling effects for patients with rotator cuff pathology were minimized (1% for both). Patients with an isolated subscapularis tear scored worse than supraspinatus/infraspinatus tears and exhibited similar dysfunction as patients with a supraspinatus/infraspinatus/subscapularis tear. An acceptable construct validity was reported with subscapularis-involved tears demonstrating higher scores with significance (P < .05). There was excellent responsiveness to change with a standardized response mean of 1.51 and effect size of 1.27 (large > 0.8). The minimal clinically important difference using a distribution and anchor-based method was 4.1 and 4.6, respectively. Among patients with rotator cuff tears in this population, a score of 22 or higher predicts a subscapularis tear 75% of the time, in spite of its low overall prevalence. Conclusion: The subscapularis shoulder score demonstrated acceptable psychometric performance for outcomes assessment in patients with rotator cuff disease. This survey can be used as an effective clinical tool to assess subscapularis function.http://www.sciencedirect.com/science/article/pii/S2666638322001736SubscapularisShoulder scoreRotator cuff tearsOutcomes assessment |
| spellingShingle | Max Hamaker, MD Blessing Enobun, MD, MPH Samir Kaveeshwar, MD S. Ashfaq Hasan, MD Brian Shiu, MD R. Frank Henn, III, MD Kelly Kilcoyne, MD Umasuthan Srikumaran, MD Gregory Gasbarro, MD Zachary R. Zimmer, MD Mohit N. Gilotra, MD, MS Reliability, validity, and responsiveness of a novel subscapularis outcome score: the Baltimore Orthopedic Subscapularis Score JSES International Subscapularis Shoulder score Rotator cuff tears Outcomes assessment |
| title | Reliability, validity, and responsiveness of a novel subscapularis outcome score: the Baltimore Orthopedic Subscapularis Score |
| title_full | Reliability, validity, and responsiveness of a novel subscapularis outcome score: the Baltimore Orthopedic Subscapularis Score |
| title_fullStr | Reliability, validity, and responsiveness of a novel subscapularis outcome score: the Baltimore Orthopedic Subscapularis Score |
| title_full_unstemmed | Reliability, validity, and responsiveness of a novel subscapularis outcome score: the Baltimore Orthopedic Subscapularis Score |
| title_short | Reliability, validity, and responsiveness of a novel subscapularis outcome score: the Baltimore Orthopedic Subscapularis Score |
| title_sort | reliability validity and responsiveness of a novel subscapularis outcome score the baltimore orthopedic subscapularis score |
| topic | Subscapularis Shoulder score Rotator cuff tears Outcomes assessment |
| url | http://www.sciencedirect.com/science/article/pii/S2666638322001736 |
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