title: A validation of the Swedish version of the WORC index in the assessment of patients treated by surgery for subacromial disease including rotator cuff syndrome.
abstract: BACKGROUND
  The Western Ontario Rotator Cuff Index (WORC) is a widely used instrument to measure quality of life in patients with subacromial pain or rotator cuff syndrome. The purpose of this study was to evaluate the psychometric properties of the Swedish version of the WORC for assessment of subacromial disease including rotator cuff syndrome treated by surgery.
  
  
  METHODS
  A total of 65 patients were included in this study, mean age 60 years (range 36-82), 42% women, all were candidates for surgery for subacromial pain conditions at two orthopedic units during 2004-2006 and 2011-2012. Calculations of the validity of Pearson's correlation coefficient, floor and ceiling effects, reliability and responsiveness have formed the basis of assessment of the WORC index properties. WORC has been tested against Western Ontario Osteoarthritis of the Shoulder (WOOS), Oxford Shoulder Score and EQ-5D. An additional 49 patients, mean age 64 years (range 36-74) 20% of whom were women, were analyzed in a WORC test-retest with ICC and also correlated to Constant-Murley Score.
  
  
  RESULTS
  The validity analysis of WORC showed high correlations with both the specific and the generic health measurement instrument. The reliability calculations of the WORC resulted in ICC = 0.97 and Cronbach's alpha = 0.97. Responsiveness was also excellent for WORC with Effect size = 1.35 and Standardized Response mean = 1.01. We found that the WORC showed a strong correlation with the WOOS (0.97) and the Constant-Murley Score (0.85). A good correlation was found with the Oxford Shoulder Score (0.74) and the EQ-5D (0.71).
  
  
  CONCLUSIONS
  The Swedish version of WORC can be considered reliable, valid and responsive for use as an assessment of outcome and a health measurement instrument for patients treated by surgery for subacromial disease including rotator cuff syndrome.
authors.affiliation: Karolinska Institute, Division of Clinical Sciences, Danderyds University Hospital, 182 88, Stockholm, Sweden. Soheila.zhaeentan@gmail.com.
authors.forename: Soheila
authors.initials: S
authors.lastname: Zhaeentan
authors.affiliation: Karolinska Institute Danderyds University Hospital, Stockholm, Sweden.
authors.forename: Markus
authors.initials: M
authors.lastname: Legeby
authors.affiliation: Division of Orthopedics, Karolinska Institute Danderyds University Hospital, Stockholm, Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Ahlström
authors.affiliation: Division of Orthopedics, Karolinska Institute Danderyds University Hospital, Stockholm, Sweden.
authors.forename: André
authors.initials: A
authors.lastname: Stark
authors.affiliation: Division of Orthopaedics Danderyds University Hospital, Stockholm, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Salomonsson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D000070636:Rotator Cuff Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D011795:Surveys and Questionnaires / Q000592:standards*; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
keywords: Quality of Life; Questionnaire; Reliability; Responsiveness; Rotator Cuff; Shoulder; Validity; WORC