title: Response shift of the Western Ontario Rotator Cuff index in patients undergoing arthroscopic rotator cuff repair.
abstract: OBJECTIVE
  This study determined the response shift in patients undergoing rotator cuff repair using the Western Ontario Rotator Cuff index (WORC), a disease-specific quality of life questionnaire. We hypothesized there would be a response shift with a positive recalibration (overestimated their preoperative disability) on the WORC and increases over time.
  
  
  METHODS
  The study prospectively included 36 patients undergoing arthroscopic rotator cuff repair. At baseline, 3 months (T1), and 1 year (T2) after surgery the WORC, EuroQol (EQ)-5D-3L, and the patient's level of satisfaction after surgery were scored. To evaluate the response shift, patients also completed the WORC at 3 months (Pre-T1) and 1 year (Pre-T2) as how they perceived themselves to have been before surgery.
  
  
  RESULTS
  The result on Pre-T1 and Pre-T2 results revealed that patients retrospectively rated their overall WORC score comparable with the baseline WORC score (Pre-T0; T0 = 40.5 ± 18.4, Pre-T1 = 45.0 ± 22.7, Pre-T2 = 34.3 ± 21.3). No response shift was observed on all domains except a negative recalibrated response shift for emotional disability on T1 (P = .04).
  
  
  CONCLUSIONS
  No significant group-level response shift was observed using the WORC, except for the subdomain emotional disability at 3 months after arthroscopic rotator cuff repair. With the absence of any shift in patient's perception on the self-administered quality of life-related WORC questionnaire, this study suggests one could retrospectively reliably conduct group-level preoperative baseline information on quality of life up to 1 year after surgery.
authors.affiliation: Department of Orthopaedic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands. Electronic address: Orthopedie-research@antoniusziekenhuis.nl.
authors.forename: Freek
authors.initials: F
authors.lastname: Hollman
authors.affiliation: Department of Orthopaedic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Wessel
authors.affiliation: Department of Orthopaedic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Nienke
authors.initials: N
authors.lastname: Wolterbeek
mesh_terms: D001182:Arthroscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D011795:Surveys and Questionnaires
keywords: Western Ontario Rotator Cuff index (WORC); perception shift; quality of life; rotator cuff repair; rotator cuff tear; shoulder