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Titre : | Defining Substantial Clinical Benefit for Patient-Rated Outcome Tools for Shoulder Impingement Syndrome (2013) |
Auteurs : | L.A. Michener ; Alison R. Snyder Valier ; P. McClure |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2013/4, 2013) |
Article en page(s) : | pp. 725-730 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Évaluation de résultat (soins) ; Rééducation et réadaptation |
Mots-clés: | Outcome Assessment (Health Care) ; Rotator cuff ; Coiffe des rotateurs |
Résumé : |
"Objective To define for 2 shoulder outcomes scales the substantial clinical benefit (SCB)a metric that defines the change amount associated with patient perception of a large meaningful improvement and that can be used to interpret change over time in the outcome score. Design Cohort. Setting Clinic. Participants Patients (N=74) with shoulder impingement syndrome. Interventions Standardized exercise and manual therapy for 6 weeks, and outcome measures completed at initial evaluation, discharge, and 6 to 8 weeks postdischarge. Main Outcome Measures Disabilities of the Arm, Shoulder and Hand (DASH), Pennsylvania Shoulder Score (Penn), and a 13-point Global Rating of Change (GROC). Patients were classified as substantially improved when they reported quite a bit better (11) or greater on the GROC at discharge and again 6 to 8 weeks after discharge. Patients with GROC Results ROC analyses revealed the SCB for the DASH was 40% (area under the curve [AUC]=.79; confidence interval [CI], .69.89) and 11 points (AUC=.63; CI, .50.76); and for the Penn, 20% (AUC=.76; CI, .65.87) and 21 points (AUC=.80; CI, .69.90). Conclusions The SCB of 40% for the DASH, and 20% and 21 points for the Penn represents substantial improvement over 6 weeks of care, which was sustained at 12 weeks. The SCB of 11 points for the DASH is not recommended for use because of poor discrimination. The SCB can be used to enable clinical decision-making and in future clinical trials. Alternative approaches such as the within- and between-group change values can produce different SCB values." |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/archives-of-physical-medicine-and-rehabilitation |