Simple Shoulder Test - validation (this time in Dutch)

Validation of the Dutch version of the Simple Shoulder Test.

These authors translated the SST  Simple Shoulder Test (SST)  into Dutch using forward and backward translations. They had a consecutive cohort of patients with shoulder problems visiting an orthopedic clinic complete the Dutch version of the SST twice within 28 days. In addition, the Dutch validated versions of the Disabilities of the Arm, Shoulder and Hand, Oxford Shoulder Score, and Constant-Murley shoulder assessment were completed for assessing construct validity.

One hundred ten patients with a mean age of 39 years (SD, 14 years), 72% male, completed the questionnaires on line.

The internal consistency was high (Cronbach α, 0.78). 

The test-retest reliability was very good (intraclass correlation coefficient, 0.92) (n = 55). 

The measurement error expressed in the standard error of measurement was 1.18, and the smallest detectable change was 3.3 on a scale from 0 to 12. 

The construct validity was supported by expected high correlations between the Dutch version of the SST and the Disabilities of the Arm, Shoulder and Hand (r = -0.74) and between the SST and the Oxford Shoulder Score (r = -0.74) and an expected moderate correlation between the SST and the Constant-Murley shoulder assessment (r = 0.59).

The authors concluded that the Dutch version of the SST is user-friendly and can easily be administered on the Web but also on paper. Eighty-six percent of their predefined hypotheses about the construct validity were confirmed.

They considered the SST as a valid and reliable instrument suitable for monitoring groups of patients and suggest in can be used for clinical trials and for comparison of study results from different countries. 

A strong point of this study is the fact that the authors had no missing data, a clear advantage of Web-based administration of the questionnaires. On the Web site, patients could not continue when items were not completed. Furthermore, all patients completed the SST the first time, and for the retest, we only had a 5% loss to follow-up.

Comment: This study adds to the evidence supporting the validity of the SST. It is unique in the fact that the questions were administered via the Web. 

The discordance with the Constant score has been previously described and is likely to be based in the fact that the Constant score is not a purely patient reported outcome instrument.

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