Saturday, November 29, 2014

The Simple Shoulder Test - a valuable patient-reported outcome tool in five languages

Validation and reliability of a Spanish version of Simple Shoulder Test (SST-Sp).

These authors conducted a two-stage observational study. The SST was adapted to Spanish through double forward and backward translation and then validated for its psychometric characteristics. Sixty-six participants with several shoulder disorders completed the SST-Sp, DASH, VAS and SF-12.

The SST-Sp showed three factors that explained the 56.1 % of variance, and the internal consistency for each factor was α = 0.738, 0.723 and 0.667, and reliability was ICC = 0.687-0.944. The factor structure was three-dimensional and supported construct validity. Criterion validity determined from the relationship between the SST-Sp and the DASH was strong.

The authors concluded that the SST-Sp was a valid shoulder outcome measure with similar psychometric properties to the original English version.

Comment: It is now generally recognized that the most important measure of treatment outcome is the improvement in the patient's self-assessment of their shoulder comfort and function. While many scoring systems, such as the Constant score, include patient self assessment, they also include observer-dependent measurements.

In that measuring self-assessed outcome takes valuable patient and provider time, the goal of the Simple Shoulder Test (SST) is to provide a tool of optimal value (= the quality of the information divided by the cost of gathering it) (see this post). Cost and inconvenience are major barriers to the use of outcome instruments. While longer and more involved tools may provide a bit more information, they also take more of the patient's and the provider's time to collect and enter into the record.

In that the shoulder community is an international one, it is important that a useful patient-reported outcome tool be validated in the common languages of the world. Spanish is the second most common language in the U.S. and one of the five most common languages spoken around the word. The validation of the SST in Spanish enables comparison of data between individuals speaking these two languages. The SST has also been validated in Dutch, Italian and Portuguese as well as English.

The Simple Shoulder Test's value is reflected in its high validity and low cost of implementation.


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