Patient-Reported Outcome Measures Used in Most Shoulder Research

Measuring patient outcomes is an important part of any orthopedic study. There are different ways of doing this, but a new study finds that patient-reported outcome measures (PROMs) is the tool of choice for most shoulder research.

In the study, “Usage Trends of Patient-reported Outcome Measures in Shoulder Literature,” published in the September 2020 issue of the Journal of the American Academy of Orthopaedic Surgeons, researchers found that PROM usage is increasing and often multiple PROMS are used to evaluate patient outcomes.

To analyze usage trends, they used PubMed to find all shoulder-based articles published in eight journals from 2007 to 2017. Each one was assessed for PROM usage, surgical approach, surgical procedure, and disease pathology.

Out of 2,462 articles, 71% used 105 unique PROMs 4,394 times during the study. PROM usage rose 18% while the use of multiple PROMS increased by 20%. However, PROMS with a clinical component grew at a slower rate.

The most used PROMS were Constant-Murley Score, American Shoulder and Elbow Surgeons Shoulder Score, Visual Analog Scale, Simple Shoulder Test, and the University of California, Los Angeles, Shoulder Rating Scale.

The PROMS that experienced the biggest jump in usage were the EuroQol 5-Dimensions Questionnaire, Shoulder Pain and Disability Index, Western Ontario Rotator Cuff Index, Western Ontario Osteoarthritis of the Shoulder Index, and Oxford Shoulder Score. All were used without a clinician component.

The researchers wrote, “PROM usage is increasing, often with multiple PROMs being used to evaluate patient outcomes. PROMS without a clinician component are growing at higher rates than their clinician-dependent counterparts, highlighting an emphasis on patient reporting of outcomes.”

They added, “This study suggests that the American Shoulder and Elbow Surgeons Shoulder Score, Oxford Shoulder Score, Visual Analog Scale—all without a mandatory clinician component and high levels of use—will be the most highly used PROMS moving forward to assess shoulder function.”