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Lee AC, Gupta R, Kelly JD, Li X, Parisien RL. Variability of MCID, SCB, and PASS Thresholds in Studies Assessing Patient-Reported Outcomes After Rotator Cuff Repair: A Systematic Review. Am J Sports Med 2024:3635465231202019. [PMID: 38318661 DOI: 10.1177/03635465231202019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
BACKGROUND An increasing reliance on patient-reported outcomes has led to greater emphasis on minimal clinically important difference (MCID), substantial clinical benefit (SCB), and Patient Acceptable Symptom State (PASS) thresholds in assessing rotator cuff repairs. PURPOSE To review the MCID, SCB, and PASS thresholds reported for patient-reported outcome measures (PROMs) after rotator cuff repair. STUDY DESIGN Systematic review; Level of evidence, 4. METHODS The PubMed, Embase, Ovid, Cochrane, and Google Scholar databases were queried for full-text journal articles in English published between January 1, 2000, and May 31, 2022. Studies with MCID, SCB, and PASS thresholds reported for patients with rotator cuff repair and a minimum of 12 months of follow-up were included. Reported MCID, SCB, and PASS thresholds and associated calculation methods were extracted. RESULTS There were 41 unique studies (6331 shoulders) that met the inclusion criteria. Of these, 37 (90%) reported MCID; 16 (39%), PASS; and 11 (27%), SCB values. The most common PROMs were the American Shoulder and Elbow Surgeons score and the Constant-Murley score. In total, 71% (29/41) of these studies referenced values in the literature, usually studies of patients undergoing rotator cuff repair (21/29). Twelve studies calculated MCID, SCB, or PASS thresholds using anchor-based approaches, whereas 6 studies also calculated thresholds using distribution-based methods. The use of MCID, SCB, and PASS in the rotator cuff repair literature is increasing, with half of the included studies published within the final 17 months of the studied period. CONCLUSION Significant variability was seen in the reporting of MCID, SCB, and PASS threshold values after rotator cuff repair. Researchers should prioritize studies that report clinical outcome thresholds calculated using anchor-based methods and should critically review both the anchor question and its response choices. Standardization of MCID, SCB, and PASS values and calculation methods will allow for a more reliable assessment of PROMs in rotator cuff repair moving forward.
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Affiliation(s)
- Alexander C Lee
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Radhika Gupta
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John D Kelly
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Xinning Li
- Department of Orthopaedic Surgery, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Robert L Parisien
- Department of Orthopaedic Surgery & Sports Medicine, Mount Sinai Health System, New York, New York, USA
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Lazrek O, Karam KM, Bouché PA, Billaud A, Pourchot A, Godeneche A, Freaud O, Kany J, Métais P, Werthel JD, Bohu Y, Gerometta A, Hardy A. A new self-assessment tool following shoulder stabilization surgery, the auto-Walch and auto-Rowe questionnaires. Knee Surg Sports Traumatol Arthrosc 2022:10.1007/s00167-022-07290-y. [PMID: 36586000 DOI: 10.1007/s00167-022-07290-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 12/13/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE Patient-reported outcome measures (PROMS) are increasingly used for patient evaluation, as well as for scientific research. Few are used for practical purposes in the clinical setting, and few are reliable enough to allow proper feedback to physicians. Two of the most commonly used assessment tools in shoulder instability are the Walch-Duplay and the Rowe scores. The aim of this study was to evaluate the validity of self-administered versions of the Walch-Duplay and Rowe scores following shoulder stabilization procedure. METHODS Between the months of May and December 2021, all patients who were followed in one of six institutions for shoulder instability were included. Patients were required to anonymously fill a self-administered version of Walch-Duplay and Rowe score. The classic scores were measured by the surgeon. Correlations between self-assessment and physician-assessment were then recorded. RESULTS A total of 106 patients were evaluated during the study period. Using the Spearman coefficient for correlation, a strong correlation (r > 0.5) was found between the results of the self-administered questionnaire and the surgeon-measured score. The difference between surgeon- and patient-administered questionnaires was non-significant. CONCLUSION The self-administered version of the Walch-Duplay and Rowe questionnaires can reliably be used in the clinical setting for post-operative follow-up of patients undergoing shoulder stabilization procedures. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Omar Lazrek
- Clinique Du Sport, 28 Boulevard Saint-Marcel, 75005, Paris, France
| | - Karam Mark Karam
- Clinique Du Sport, 28 Boulevard Saint-Marcel, 75005, Paris, France.
| | | | - Anselme Billaud
- Centre de Chirurgie Orthopédique et Sportive, Mérignac, France
| | - Auriane Pourchot
- Hôpital Ambroise-Pare, 9 Av. Charles de Gaulle, 92100, Boulogne-Billancourt, France
| | | | | | - Jean Kany
- Clinique de l'Union-Ramsay Santé, Toulouse, France
| | - Pierre Métais
- Hopital Prive de la Châtaigneraie-ELSAN, Clermont-Ferrand, France
| | - Jean-David Werthel
- Hôpital Ambroise-Pare, 9 Av. Charles de Gaulle, 92100, Boulogne-Billancourt, France
| | - Yoann Bohu
- Clinique Du Sport, 28 Boulevard Saint-Marcel, 75005, Paris, France
| | | | - Alexandre Hardy
- Clinique Du Sport, 28 Boulevard Saint-Marcel, 75005, Paris, France
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Sadowski A, Wexler RS, Hanes D, Buttolph L, Torrens T, Moehle J, Sarrar H, Harnett J, Zava DT, Bradley R. Meditative practices, stress and sleep among students studying complementary and integrative health: a cross-sectional analysis. BMC Complement Med Ther 2022; 22:127. [PMID: 35513823 PMCID: PMC9070612 DOI: 10.1186/s12906-022-03582-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 03/25/2022] [Indexed: 11/24/2022] Open
Abstract
Background The International Cohort on Lifestyle Determinants of Health (INCLD Health) is an ongoing, prospective cohort study assessing the health behaviours and lifestyles of higher education students, including their use of specialty diets and complementary and integrative health (CIH) practices. Purpose: This cross-sectional analysis of the INCLD Health cohort aims to (1) evaluate the associations between perceived stress, sleep disturbance, and meditative practices with diurnal salivary free cortisol and (2) evaluate the associations of meditative practices as well as mind-body practices with perceived stress and sleep disturbance. Methods Serial multivariable linear regression models, adjusting for sociodemographic and lifestyle behaviours, were used to assess associations of (1) perceived stress, sleep disturbance, and meditative practices with salivary cortisol, and (2) meditative practices as well as mind-body practices with perceived stress and sleep disturbance. Meditative and mind-body practices were evaluated using a stress-management and self-care survey; perceived stress and sleep disturbance were evaluated using the 10-item Perceived Stress Scale (PSS), and the patient reported outcome measures information system-29 (PROMIS-29) sleep sub-score respectively. Salivary cortisol was collected at 4 time points over a 24-hour period and area under the curve (AUC) calculations conducted. Results 82.5% (n = 80) of participants utilized at least monthly meditative practices. Greater disturbed sleep, but not perceived-stress, meditative, nor mind-body practices was independently associated with increased AUC cortisol (b = 0.02, 95% CI: 0.002–0.05, p = 0.03) after adjusting for age, sex, race, ethnicity, and BMI. Neither meditative nor mind-body practices were associated with perceived stress or disturbed sleep. Conclusions Among INCLD Health participants, greater sleep disturbance, but not perceived stress or meditative practices were associated with daytime cortisol. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03582-5.
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Affiliation(s)
- Adam Sadowski
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, USA.
| | - Ryan S Wexler
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, USA
| | - Douglas Hanes
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, USA
| | - Lita Buttolph
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, USA
| | - Tediana Torrens
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, USA
| | - Jillian Moehle
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, USA
| | - Hadil Sarrar
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, USA
| | - Joanna Harnett
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, Australia
| | | | - Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, USA.,Herbert Wertheim School of Public Health, University of California, La Jolla, San Diego, CA, USA
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Sudah SY, Puzzitiello RN, Nasra MH, Moverman MA, Pagani NR, Guss MS, Menendez ME. Nonoperative treatment of distal humerus fractures in the elderly yields satisfactory functional outcomes and low conversion to delayed surgery: a systematic review. JSES REVIEWS, REPORTS, AND TECHNIQUES 2022; 2:96-102. [PMID: 37588281 PMCID: PMC10426674 DOI: 10.1016/j.xrrt.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Background Distal humerus fractures (DHFs) pose a treatment challenge in elderly patients. We sought to systematically review and report the clinical outcomes of the nonoperative approach (eg, "bag of bones") for the treatment of these injuries and the rate of conversion to delayed surgery. Methods A comprehensive review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines was conducted. Studies involving outcomes after nonoperative treatment of DHF in patients >65 years of age were included from 1985 to present. Data regarding patient age, DHF type, nonoperative treatment method, complications, conversion to delayed surgery, range of motion, union rate, and surgeon- and patient-reported outcome measures were extracted. Results A total of five studies met inclusion criteria (all level IV evidence), yielding a total of 143 patients (mean age: 73.5 years to 87.4 years) with 7.1 months to 55 months of follow-up. The mean Mayo Elbow Performance Index scores were good to excellent across several studies (range 83-93.1). Multiple studies reported good range of motion (mean arc of motion: 81 to 106 degrees) and low levels of upper extremity disability (mean Quick Disability of the Arm-Shoulder-Hand scores: 31.3 to 38.5) at the final follow-up. The rate of conversion to total elbow arthroplasty and operative fixation ranged from 0% to 7.5% and 0% to 5%, respectively. Conclusion Nonoperative management of distal humerus fractures in the elderly seems to be associated with acceptable functional outcomes and low rates of delayed surgery. This information is important for patient counseling and treatment decision-making.
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Affiliation(s)
- Suleiman Y. Sudah
- Department of Orthopedic Surgery, Monmouth Medical Center, Long Branch, NJ, USA
| | - Richard N. Puzzitiello
- Department of Orthopedic Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | | | - Michael A. Moverman
- Department of Orthopedic Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Nicholas R. Pagani
- Department of Orthopedic Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Michael S. Guss
- Department of Orthopedic Surgery, Newton-Wellesley Hospital, Newton, MA, USA
| | - Mariano E. Menendez
- Department of Orthopedic Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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Santana MJ, Tomkins DJ. Correction to: Patient-led use of patient-reported outcome measure in self-Management of a Rotator Cuff Injury. J Patient Rep Outcomes 2021; 5:74. [PMID: 34406522 PMCID: PMC8374013 DOI: 10.1186/s41687-021-00340-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Maria J Santana
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, TRW Building, 3rd Floor, Calgary, Alberta, T2N 4Z6, Canada.
| | - Darrell J Tomkins
- Department of Medical Genetics, University of Alberta, Edmonton, Canada
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