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World J Orthop. Nov 18, 2014; 5(5): 623-633
Published online Nov 18, 2014. doi: 10.5312/wjo.v5.i5.623
Functional outcomes assessment in shoulder surgery
James D Wylie, James T Beckmann, Erin Granger, Robert Z Tashjian
James D Wylie, James T Beckmann, Erin Granger, Robert Z Tashjian, Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT 84108, United States
Author contributions: Wylie JD, Beckmann JT, Granger E and Tashjian RZ solely contributed to the concept, writing and editing of this paper.
Correspondence to: Robert Z Tashjian, MD, Department of Orthopaedic Surgery University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, United States.
Telephone: +1-801-5875457 Fax: +1-801-5875411
Received: May 26, 2014
Revised: July 3, 2014
Accepted: July 18, 2014
Published online: November 18, 2014

The effective evaluation and management of orthopaedic conditions including shoulder disorders relies upon understanding the level of disability created by the disease process. Validated outcome measures are critical to the evaluation process. Traditionally, outcome measures have been physician derived objective evaluations including range of motion and radiologic evaluations. However, these measures can marginalize a patient’s perception of their disability or outcome. As a result of these limitations, patient self-reported outcomes measures have become popular over the last quarter century and are currently primary tools to evaluate outcomes of treatment. Patient reported outcomes measures can be general health related quality of life measures, health utility measures, region specific health related quality of life measures or condition specific measures. Several patients self-reported outcomes measures have been developed and validated for evaluating patients with shoulder disorders. Computer adaptive testing will likely play an important role in the arsenal of measures used to evaluate shoulder patients in the future. The purpose of this article is to review the general health related quality-of-life measures as well as the joint-specific and condition specific measures utilized in evaluating patients with shoulder conditions. Advances in computer adaptive testing as it relates to assessing dysfunction in shoulder conditions will also be reviewed.

Keywords: Shoulder, Functional outcome, Quality-of-life, Health utility measure, Patient reported outcome

Core tip: Health related quality of life evaluation includes general health measures, health utility measures, general shoulder measures and condition specific shoulder measures. A combination of a general/health utility measure with a shoulder measure or condition specific measure is needed to fully capture outcomes in the treatment of shoulder conditions.