PMID- 37786475
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231004
IS  - 2325-9671 (Print)
IS  - 2325-9671 (Electronic)
IS  - 2325-9671 (Linking)
VI  - 11
IP  - 9
DP  - 2023 Sep
TI  - Assessment of Thresholds for Clinically Relevant Change in the 
      Pediatric/Adolescent Shoulder Survey After Shoulder Instability Surgery: Factors 
      Associated With Meaningful Improvement in Outcomes.
PG  - 23259671231196943
LID - 10.1177/23259671231196943 [doi]
LID - 23259671231196943
AB  - BACKGROUND: The pediatric/adolescent shoulder survey (PASS) score is a subjective 
      measure of shoulder symptomology in younger patients. PURPOSE: To establish the 
      minimal clinically important difference (MCID) and minimal detectable change 
      (MDC) for the PASS score in adolescents after surgical treatment for shoulder 
      instability. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Included 
      were patients aged 12.5 to 23 years who underwent surgical treatment for shoulder 
      instability and who had completed PASS forms preoperatively and at 3 months 
      postoperatively. The MCID was established using an anchor-based approach, with 
      the Single Assessment Numeric Evaluation (SANE) and shortened version of the 
      Disabilities of the Arm, Shoulder and Hand (QuickDASH) as anchors. Change in PASS 
      score between anchor groups was determined using receiver operating 
      characteristic curve analysis. MDC with 90% confidence (MDC(90)) was also 
      calculated. Range of motion and strength data at 3-month follow-up were evaluated 
      to identify the optimal postoperative PASS score. Factors associated with 
      improvement in PASS score beyond the MDC(90) and MCID were determined in a subset 
      of patients with >/=6-month follow-up data. RESULTS: A total of 95 patients were 
      included. The mean PASS score improved significantly from preoperatively to 
      postoperatively (57 +/- 15 to 75 +/- 16; P < .001). The anchor-based MCID ranged from 
      12.5 to 13.2 points, with an area under the receiver operating characteristic 
      (AUC) curve of 0.87 for the SANE and 0.99 for the QuickDASH. The MDC(90) was 16.5 
      points. The optimal PASS score at 3 months after surgery was >/=85 (AUC, 0.66). 
      Shorter duration of symptoms, lower preoperative forward elevation, and higher 
      preoperative external rotation were associated with improvement in PASS score 
      above the MDC(90) and/or MCID for the subset of patients (n = 25) with >/=6-month 
      follow-up data. Increased number of suture anchors, less preoperative external 
      rotation deficit, and number of previous dislocations had a moderate effect on 
      improvement in outcomes. CONCLUSION: A postoperative increase in PASS score of 
      >/=16.5 points had a 90% chance of being a true-positive change, while a score 
      change of approximately 13 points was likely clinically relevant. The optimal 
      PASS score after surgery was >/=85. Shorter duration of symptoms, preoperative 
      range of motion, number of surgical anchors, and number of previous dislocations 
      were associated with achieving a clinically relevant improvement in PASS score at 
      minimum 6 months postoperatively.
CI  - (c) The Author(s) 2023.
FAU - Wallis-Lang, Kendahl
AU  - Wallis-Lang K
AD  - University of California, San Diego, San Diego, California, USA.
FAU - Bastrom, Tracey P
AU  - Bastrom TP
AD  - Department of Orthopedics, Rady Children's Hospital, San Diego, California, USA.
FAU - Boutelle, Kelly E
AU  - Boutelle KE
AD  - Department of Orthopedics, Rady Children's Hospital, San Diego, California, USA.
FAU - Wagle, Abigail
AU  - Wagle A
AD  - Department of Orthopedics, Rady Children's Hospital, San Diego, California, USA.
FAU - Pennock, Andrew T
AU  - Pennock AT
AD  - University of California, San Diego, San Diego, California, USA.
AD  - Department of Orthopedics, Rady Children's Hospital, San Diego, California, USA.
FAU - Edmonds, Eric W
AU  - Edmonds EW
AD  - University of California, San Diego, San Diego, California, USA.
AD  - Department of Orthopedics, Rady Children's Hospital, San Diego, California, USA.
LA  - eng
PT  - Journal Article
DEP - 20230929
PL  - United States
TA  - Orthop J Sports Med
JT  - Orthopaedic journal of sports medicine
JID - 101620522
PMC - PMC10541762
OTO - NOTNLM
OT  - MCID
OT  - patient-reported outcome
OT  - pediatric and adolescent shoulder survey
OT  - pediatrics
OT  - shoulder
OT  - shoulder instability
EDAT- 2023/10/03 06:46
MHDA- 2023/10/03 06:47
PMCR- 2023/09/29
CRDT- 2023/10/03 03:38
PHST- 2023/04/18 00:00 [received]
PHST- 2023/05/04 00:00 [accepted]
PHST- 2023/10/03 06:47 [medline]
PHST- 2023/10/03 06:46 [pubmed]
PHST- 2023/10/03 03:38 [entrez]
PHST- 2023/09/29 00:00 [pmc-release]
AID - 10.1177_23259671231196943 [pii]
AID - 10.1177/23259671231196943 [doi]
PST - epublish
SO  - Orthop J Sports Med. 2023 Sep 29;11(9):23259671231196943. doi: 
      10.1177/23259671231196943. eCollection 2023 Sep.