title: Inter-rater agreement and reliability of the COSMIN (COnsensus-based Standards for the selection of health status Measurement Instruments) Checklist Factor structure and validity of the shoulder pain and disability index in a population-based study of people with shoulder symptoms Agreement, reliability and validity in 3 shoulder questionnaires in patients with rotator cuff disease Shoulder disability questionnaire design and responsiveness of a functional status measure. The responsiveness of the Shoulder Disability Questionnaire Responsiveness of the Shoulder Pain and Disability Index in patients with adhesive capsulitis Development of a methodological PubMed search filter for finding studies on measurement properties of measurement instruments Translation, adaptation and validation of the Shoulder Rating Questionnaire (SRQ) into the Dutch language A comparison of functional, patient-based scores in subacromial impingement. Measurement of shoulder related disability: results of a validation study. Shoulder-specific disability measures showed acceptable construct validity and responsiveness. Development of a shoulder pain and disability index.
abstract: Background The COSMIN checklist is a tool for evaluating the method ological quality of studies on measurement properties of health-related patient-reported outcomes . The aim of this study is to determine the inter-rater agreement and reliability of each item score of the COSMIN checklist ( n = 114 ) . Methods 75 articles evaluating measurement properties were r and omly selected from the bibliographic data base compiled by the Patient-Reported Outcome Measurement Group , Oxford , UK . Raters were asked to assess the method ological quality of three articles , using the COSMIN checklist . In a one-way design , percentage agreement and intraclass kappa coefficients or quadratic-weighted kappa coefficients were calculated for each item . Results 88 raters participated . Of the 75 selected articles , 26 articles were rated by four to six participants , and 49 by two or three participants . Overall , percentage agreement was appropriate ( 68 % was above 80 % agreement ) , and the kappa coefficients for the COSMIN items were low ( 61 % was below 0.40 , 6 % was above 0.75 ) . Reasons for low inter-rater agreement were need for subjective judgement , and accustom to different st and ards , terminology and definitions . Conclusions Results indicated that raters often choose the same response option , but that it is difficult on item level to distinguish between articles . When using the COSMIN checklist in a systematic review , we recommend getting some training and experience , completing it by two independent raters , and reaching consensus on one final rating . Instructions for using the checklist are improved Background The Shoulder Pain and Disability Index ( SPADI ) is a self-administered question naire that aims to measure pain and disability associated with shoulder disease . The aim of the present study was to investigate the construct validity and factor structure of the SPADI in a population -based study of patients with self-reported chronic shoulder symptoms . Methods The North West Adelaide Health Study is a representative longitudinal cohort study of people aged 18 years and over . The original sample was r and omly selected and recruited by telephone interview . Overall , 3 206 participants returned to the clinic during the second stage ( 2004 - 2006 ) and were asked to report whether they had pain , aching or stiffness on most days in either of their shoulders . Data was also collected on body mass index and shoulder range of motion ( ROM ) and demographic factors . The SPADI ( numeric rating scale ) was administered to participants with shoulder symptoms . Principal components factor analysis , with varimax rotation of factor loadings , was used to assess subscale structure of SPADI . Correlations between the SPADI , shoulder ROM and SF-36 were performed . Results Overall , 22.3 % of participants indicated that they had pain , aching or stiffness in either of their shoulders . SPADI results were available for 588 of participants with current shoulder symptoms . The internal consistency of the SPADI subscales were high ( Cronbach 's alpha > 0.92 ) . Two factors , explaining 61.4 % of the total variance were extracted by factor analysis . These were interpreted as disability and pain respectively . There was a strong negative correlation between SPADI disability subscale scores and shoulder range of motion . SPADI disability , but not pain , subscale scores were correlated with age . Conclusions The SPADI is a valid measure to assess pain and disability in people with shoulder pain in a population -based study . In this setting , the SPADI had a bidimensional structure with both pain and disability subscales Background Self-report question naires play an important role as outcome measures in shoulder research . Having an estimate of the measurement error of these question naires is of importance when assessing follow-up results after treatment and when planning intervention studies . The aim of this study was to cross-culturally adapt the Norwegian version of the OSS and WORC question naire and examine and compare agreement , reliability and construct validity of the disease-specific shoulder question naire WORC with two commonly used shoulder question naires , SPADI and OSS , in patients with rotator cuff disease . Methods 74 patients with rotator cuff disease were recruited from the outpatient clinic of the Physical Medicine and Rehabilitation Department at Ullevaal University Hospital in Oslo , Norway . A test-retest design was used , and the question naires were filled out by the patients at the clinic , with a one week interval between test administrations . Agreement ( repeatability coefficient ) , reliability ( ICC ) and construct validity were examined and compared for WORC , SPADI and OSS . Results Reliability analysis was restricted to the 55 patients ( 51 ± 10 yrs ) who reported no change between test administrations according to scoring on a global scale . The agreement , reliability and construct validity was moderate for all three question naires with ICC ranging from 0.83 to 0.85 , repeatability coefficient from 16.1 to 19.7 and Spearman rank correlations between total scores from r = 0.57 to 0.69 . There was a lower degree of floor and ceiling effects in SPADI compared to WORC and OSS . Conclusion We conclude that the agreement and reliability of the three shoulder question naires examined , WORC index , SPADI and OSS are acceptable and that differences between scores were small . The Norwegian version of the question naires is acceptable for assessing Norwegian-speaking patients with rotator cuff disease . The moderate agreement and construct validity should be taken into consideration when assessing follow-up results after treatment and in the planning of prospect i ve studies The Shoulder Disability Question naire ( SDQ ) is a measure covering 16 items design ed to evaluate functional status limitation in patients with shoulder disorders . The responsiveness of the SDQ was evaluated for 180 patients with soft tissue shoulder disorders , without underlying systemic disorders . These patients participated in a r and omized placebo-controlled trial , in which ultrasound and electrotherapy appeared to be ineffective as adjuvants to st and ardized exercise therapy . At baseline and at 6-week follow-up , patients completed the  SDQ  and rated severity of shoulder pain and their chief complaint , while a research physiotherapist rated severity of symptoms and restriction of mobility . At the 6-week follow-up , patients also rated overall change since baseline . According to the calibrated responsiveness ratio ( CRR ) and the area under the receiver-operator characteristic curve ( AUC ) the SDQ discriminates accurately between self-rated clinical ly stable and improved subjects . The presented results suggest that the SDQ is as responsive as the compared outcome measures , and therefore is ready for use in clinical trials Objective —To evaluate the responsiveness of the Shoulder Disability Question naire ( SDQ ) . Methods —The study was conducted within the framework of an observational study on shoulder disorders in primary care . After first presentation of their complaints to the general practitioner and after one and six months , participants completed the SDQ , a single question on functional status ( FSQ ) , and an ordinal 11 point scale for the severity of pain ( PSS ) . Responsiveness of the SDQ was evaluated compared with that of the FSQ and PSS , by calculating responsiveness ratios and by plotting receiver operating characteristic ( ROC ) curves . Recovery according to the patient was used as an external criterion for clinical ly relevant improvement ( complete recovery or much improved on a six point Likert scale was denoted as clinical ly relevant improvement ) . Results —A total of 349 consecutive patients with shoulder disorders were enrolled in the observational study . Response rates ranged between 96 % and 89 % . Responsiveness ratios were slightly higher for the PSS compared with the SDQ ( 2.53 versus 2.22 at one month , 2.24 versus 1.89 at six months ) . The area under the ROC curve was 0.84 for both the SDQ and the PSS , and 0.72 for the FSQ . Conclusion —The results of this study confirm the responsiveness of the SDQ , making it a useful instrument to assess functional disability in longitudinal studies Background Instruments design ed to measure the subjective impact of painful shoulder conditions have become essential in shoulder research . The Shoulder Pain and Disability Index ( SPADI ) is one of the most extensively used scales of this type . The objective of this study was to investigate reproducibility and responsiveness of the SPADI in patients with adhesive capsulitis . Methods SPADI test-retest reproducibility was estimated by the " intraclass correlation coefficient " ( ICC ) and the " smallest detectable difference " ( SDD ) . Responsiveness was assessed by exploring baseline and follow-up data recorded in a recently reported clinical trial regarding hydrodilatation and corticosteroid injections in 76 patients with adhesive capsulitis .  " St and ardized response mean " ( SRM ) and " reliable change proportion " ( RCP ) for SPADI were compared with corresponding figures for shoulder range-of-motion ( ROM ) . The relationship between SPADI and ROM change scores was investigated through correlation and linear regression analyses . Results Results for test-retest reproducibility indicated a smallest detectable difference of 17 points on the 0–100 scale , and an intraclass correlation coefficient of 0.89 . The SPADI was generally more responsive than ROM . Weak to moderately strong associations were identified between SPADI and ROM change scores . According to the regression model , the three variables baseline SPADI , baseline active ROM and change in active ROM together explained 60 % of the variance in SPADI improvement . Conclusion This study supports the use of SPADI as an outcome measure in similar setting Objectives For the measurement of  patient-reported outcomes , such as ( health-related ) quality of life , often many measurement instruments exist that intend to measure the same construct . To facilitate instrument selection , our aim was to develop a highly sensitive search filter for finding studies on measurement properties of measurement instruments in PubMed and a more precise search filter that needs less abstract s to be screened , but at a higher risk of missing relevant studies . Methods A r and om sample of 10,000 PubMed records ( 01 - 01 - 1990 to 31 - 12 - 2006 ) was used as a gold st and ard . Studies on measurement properties were identified using an exclusion filter and h and search ing . Search terms were selected from the relevant records in the gold st and ard as well as from 100 systematic review s of measurement properties and combined based on sensitivity and precision . The performance of the filters was tested in the gold st and ard as well as in two validation sets , by calculating sensitivity , precision , specificity , and number needed to read . Results We identified 116 studies on measurement properties in the gold st and ard . The sensitive search filter was able to retrieve 113 of these 116 studies ( sensitivity 97.4 % , precision 4.4 % ) . The precise search filter had a sensitivity of 93.1 % and a precision of 9.4 % . Both filters performed very well in the validation sets . Conclusion The use of these search filters will contribute to evidence -based selection of measurement instruments in all medical fields Objective : To translate and adapt the original English version of the Shoulder Rating Question naire ( SRQ ) into the Dutch language ( SRQ-DLV ) and evaluate its internal consistency , reliability , validity and responsiveness to clinical changes . Design : Prospect i ve study . Setting : Outpatient departments of orthopaedics , radiology and physical therapy of an academic and a non-academic hospital . Subjects : One hundred and seven patients treated for unilateral shoulder disorder ( adhesive capsulitis 68 , calcifying tendinitis 22 , impingement syndrome or rotator cuff tear 17 ) . Methods : The original SRQ was translated and adapted following international guidelines . The SRQ-DLV was used among other measures of body function and structure , activities and societal participation in order to determine reliability , internal consistency , validity and responsiveness . Assessment s were done at baseline and three months after treatment , with the SRQ-DLV being re-administered within one week before the baseline measurement and the start of the treatment for testing reliability . Results : Cronbach 's alpha for internal consistency was 0.89 for the total question naire and 0.81 , 0.80 , 0.72 and 0.84 for the domains pain , daily activities , sports/recreational activities and work , respectively . Test-retest reliability of the SRQ-DLV and its subscales ranged from 0.63 to 0.86 . The summary score of the SRQ-DLV correlated with measures of shoulder function , daily activities and quality of life . Except for the work subscale of the SRQ-DLV , large effect sizes , reflecting its responsiveness to clinical changes after treatment , were found for both the summary and the subscales scores . Conclusions : Empirical data support that the SRQ-DLV is a reliable , valid and responsive measure to be used in clinical trials including Dutch patients with various shoulder disorders The goal of this study was to compare the  Oxford Shoulder Score ( OSS ) , the  Shoulder Pain and Disability Index ( SPADI ) , and the Short Form 36 ( SF-36 ) for their correlation , agreement , sensitivity to change , and test-retest reliability in patients with a clinical diagnosis of subacromial impingement . All patients attending a specialist subacromial impingement clinic over a 6-month period completed the OSS , SPADI , and SF-36 at each visit . A total of 323 sets of observations were recorded in 110 patients . The first 38 of these patients were also sent the question naires to complete before their visit . There was good correlation between the OSS and SPADI scores ( correlation coefficient = 0.85 ) and good agreement between the scores on each scale ( weighted kappa = 0.79 ) . The correlation with total SF-36 was poor ( 0.37 for OSS and 0.26 for SPADI ) . The OSS and SPADI showed good effect sizes compared with the total SF-36 score and good test-retest reliability . These data support the use of the OSS or SPADI in patients with subacromial impingement OBJECTIVE --To develop and vali date a question naire to quantify disability associated with shoulder symptoms . METHODS --A set of questions relevant to shoulder symptoms from a general disability interview was developed and the question naire applied to a cross-sectional population survey and a prospect i ve study of general practice attenders . Subjects included adults who reported current shoulder pain in a population survey and patients from three general practice s who attended with shoulder symptoms during a six month period . The main outcome measures were : frequency of problems with daily living related to shoulder symptoms , total score on 22-item disability question naire , and measures of shoulder movement . RESULTS --A higher proportion ( 80 % ) of patients attending their general practitioner with shoulder symptoms had five or more disabilities compared with subjects reporting shoulder pain in a community survey ( 34 % ) . The ranked frequency with which each disability was reported was similar in the two groups , although sleep disturbance was the most common problem in consulters . Self-reported disability is correlated with measures of restricted shoulder movement . CONCLUSION --This disability question naire was simple to complete and should prove useful for both general practice and population -based studies of shoulder pain OBJECTIVE To compare the construct validity and responsiveness of the Shoulder Pain and Disability Index ( SPADI ) , Croft Index , and disabilities of the arm , shoulder , and h and ( DASH ) for patients with adhesive capsulitis and to compare these with pain on a visual analog scale , the Health Assessment Question naire , and the problem-elicitation technique . STUDY DESIGN AND SETTING Two r and omized double-blind placebo-controlled trials of interventions for adhesive capsulitis were performed . Both trials recruited patients from community-based physiotherapy practice s. Responsiveness at 3 weeks postbaseline was assessed using four responsiveness parameters and three external criteria for improvement . RESULTS Correlations between the shoulder-specific measures ranged from 0.55 to 0.65 at baseline and 0.49 - 0.55 for the 3-week change scores . Greater responsiveness was seen for the SPADI . The effect size for the SPADI ranged from 1.20 to 1.64 , for the Croft Index from 0.87 to 1.21 , and for the DASH from 0.55 to 0.83 . Rankings were similar across the four responsiveness parameters and the three external criteria for improvement . Correlations between the shoulder-specific and generic measures for baseline and 3-week change scores were lower than those among the shoulder-specific measures ( range : 0.17 - 0.60 ) . CONCLUSION The shoulder-specific disability measures showed acceptable construct validity and responsiveness with a small but consistent overall advantage for the SPADI A  shoulder pain and disability index ( SPADI ) was developed to measure the pain and disability associated with shoulder pathology . The SPADI is a self-administered index consisting of 13 items divided into two subscales : pain and disability . Thirty-seven male patients with shoulder pain were used in a study to examine the measurement characteristics of the SPADI . Test-retest reliability of the SPADI total and subscale scores ranged from 0.6377 to 0.6552 . Internal consistency ranged from 0.8604 to 0.9507 . SPADI total and subscale scores were highly negatively correlated with shoulder range of motion ( ROM ) supporting the criterion validity of the index . Principal components factor analysis with and without varimax rotation supported the construct validity of the total SPADI and its subscales . High negative correlations between changes in SPADI scores and changes in shoulder ROM indicated the SPADI detected changes in clinical status over short time intervals . The SPADI should prove useful for both clinical and research purpose
target: The SPADI is the most frequently evaluated PROM and its measurement properties seem adequate apart from a lack of information regarding its measurement error and content validity .
  Dutch users could use either the SDQ or the SST .
  In Tamil , Slovene , Spanish and the Danish language s , the evaluated PROMs were not yet of acceptable validity .
  None of these PROMs showed strong positive evidence for all measurement properties .
background: Objective To critically appraise and compare the measurement properties of self-administered patient-reported outcome measures ( PROMs ) focussing on the shoulder , assessing “ activity limitations . ”