title: The Elbow Self-Assessment Score (ESAS): development and validation of a new patient-reported outcome measurement tool for elbow disorders.
abstract: OBJECTIVE
  To develop and validate an elbow self-assessment score considering subjective as well as objective parameters.
  
  
  METHODS
  Each scale of the American Shoulder and Elbow Surgeons-Elbow Score, the Broberg and Morrey rating system (BMS), the Patient-Rated Elbow Evaluation (PREE) Questionnaire, the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES) and the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) was analysed, and after matching of the general topics, the dedicated items underwent a fusion to the final ESAS's item and a score containing 22 items was created. In a prospective clinical study, validity, reliability and responsiveness in physically active patients with traumatic as well as degenerative elbow disorders were evaluated.
  
  
  RESULTS
  Validation study included 103 patients (48 women, 55 men; mean age 43 years). A high test-retest reliability was found with intraclass correlation coefficients of at least 0.71. Construct validity and responsiveness were confirmed by correlation coefficients of -0.80 to -0.84 and 0.72-0.84 (p <0.05). Correlation coefficients of the ESAS and well-established elbow rating systems BMS, PREE, MEPS, OES and Quick-DASH were between 0.70 and 0.90 (p < 0.05).
  
  
  CONCLUSIONS
  With this novel Elbow Self-Assessment Score (ESAS), a valid and reliable instrument for a qualitative self-assessment of subjective and objective parameters (e.g. range of motion) of the elbow joint is demonstrated. Quantitative measurement of elbow function may not longer be limited to specific elbow disorders or patient groups. The ESAS seems to allow for a broad application in clinical research studying elbow patients and may facilitate the comparison of treatment results in elbow disorders. The treatment efficacy can be easily evaluated, and treatment concepts could be reviewed and revised.
  
  
  METHODS
  Diagnostic study, Level III.
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstrasse 22, 81675, Munich, Germany. marc.beirer@mri.tum.de.
authors.forename: Marc
authors.initials: M
authors.lastname: Beirer
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstrasse 22, 81675, Munich, Germany.
authors.forename: Henrik
authors.initials: H
authors.lastname: Friese
authors.affiliation: Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Lenich
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstrasse 22, 81675, Munich, Germany.
authors.forename: Moritz
authors.initials: M
authors.lastname: Crönlein
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstrasse 22, 81675, Munich, Germany.
authors.forename: Gunther H
authors.initials: GH
authors.lastname: Sandmann
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstrasse 22, 81675, Munich, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Biberthaler
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstrasse 22, 81675, Munich, Germany.
authors.forename: Chlodwig
authors.initials: C
authors.lastname: Kirchhoff
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstrasse 22, 81675, Munich, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Siebenlist
mesh_terms: D000328:Adult; D004550:Elbow / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D000071066:Patient Reported Outcome Measures; D011446:Prospective Studies; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D000092464:Elbow Injuries
keywords: Elbow disorders; Outcome measurement tool; Reliability; Responsiveness; Self-assessment score; Validity