title: A Systematic Review of the Psychometric Properties of Patient-Reported Outcome Instruments for Use in Patients With Rotator Cuff Disease.
abstract: BACKGROUND
  Many patient-reported outcome instruments (or questionnaires) have been developed for use in patients with rotator cuff disease. Before an instrument is implemented, its psychometric properties should be carefully assessed, and the methodological quality of papers that investigate a psychometric component of an instrument must be carefully evaluated. Together, the psychometric evidence and the methodological quality can then be used to arrive at an estimate of an instrument's quality.
  
  
  OBJECTIVE
  To identify patient-reported outcome instruments used in patients with rotator cuff disease and to critically appraise and summarize their psychometric properties to guide researchers and clinicians in using high-quality patient-reported outcome instruments in this population.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  Systematic literature searches were performed to find English-language articles concerning the development or evaluation of a psychometric property of a patient-reported outcome instrument for use in patients with rotator cuff disease. Methodological quality and psychometric evidence were critically appraised and summarized through 2 standardized sets of criteria.
  
  
  RESULTS
  A total of 1881 articles evaluating 39 instruments were found per the search strategy, of which 73 articles evaluating 16 instruments were included in this study. The Constant-Murley score, the DASH (Disability of the Arm, Shoulder, and Hand), and the Shoulder Pain and Disability Index were the 3 most frequently evaluated instruments. In contrast, the psychometric properties of the Korean Shoulder Scoring System, Shoulder Activity Level, Subjective Shoulder Value, and Western Ontario Osteoarthritis Shoulder index were evaluated by only 1 study each. The Western Ontario Rotator Cuff Index was found to have the best overall quality of psychometric properties per the established criteria, with positive evidence found in internal consistency, reliability, content validity, hypothesis testing, and responsiveness. The DASH, Shoulder Pain and Disability Index, and Simple Shoulder Test had good evidence in support of internal consistency, reliability, structural validity, hypothesis testing, and responsiveness. Inadequate methodological quality was found across many studies, particularly in internal consistency, reliability, measurement error, hypothesis testing, and responsiveness.
  
  
  CONCLUSIONS
  More high-quality methodological studies should be performed to assess the properties in all identified instruments.
authors.affiliation: Department of Orthopedic Surgery, University of Michigan, Ann Arbor, Michigan, USA hsiaomin@umich.edu.
authors.forename: Hsiaomin
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Surgery, Dalhousie University, Saint John Regional Hospital, Saint John, New Brunswick, Canada.
authors.forename: John A
authors.initials: JA
authors.lastname: Grant
authors.affiliation: Department of Orthopedic Surgery, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Bruce S
authors.initials: BS
authors.lastname: Miller
authors.affiliation: Amgen Inc, Thousand Oaks, California, USA.
authors.forename: Faisal M
authors.initials: FM
authors.lastname: Mirza
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Joel J
authors.initials: JJ
authors.lastname: Gagnier
mesh_terms: D006801:Humans; D010003:Osteoarthritis / Q000175:diagnosis / Q000523:psychology*; D063868:Patient Outcome Assessment; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D017006:Rotator Cuff; D012785:Shoulder Joint; D011795:Surveys and Questionnaires
keywords: Patient-reported outcomes; psychometric properties; rotator cuff disease; shoulder