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  Agreement between patient-based and clinician-based assessment of the shoulder


Background

Patient home-based self-assessments after shoulder surgery have the potential to aid clinicians in reducing clinic time and decreasing follow-up requirements. The purpose of this systematic review was to determine the correlation between patient-based and physician-assessed outcome measures for range of motion (ROM), strength, and shoulder function.

Methods

This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials databases were searched. All studies comparing patient-reported and clinician-based assessments of shoulder ROM, strength, and function were eligible for inclusion. Studies that included patient or clinician assessment only, description of shoulder diseases or treatments only, and animal- or cadaveric-based studies were excluded. More than 250 abstracts were searched, and 4 studies were found eligible.

Results

Patients assessed their shoulder ROM, strength, and function with moderate-to-high accuracy compared with clinical assessment. There was less agreement between patients and clinicians regarding the symptomatic shoulder compared with the contralateral shoulder. There was less agreement between patients and clinicians on rotation than forward elevation. Patients who were less satisfied with their shoulder had less agreement with clinicians.

Conclusion

There is moderate-to-high agreement between patients and clinicians in the assessment of the shoulder after surgery. Methods of assessment of rotation could be reviewed to create a more exact self-assessment tool.

Keywords:

Patient-derived, patient-reported, clinician-assessed, clinician reported, shoulder assessment, agreement

Geplaatst door: Paul van der Tas op: 16 november 2017