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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2012 June;63(3):169-76
A reliability study of the ases Score and Oxford Score in patients affected by shoulder diseases
Gastaldo C. 1, Fissore L. 1, Gennari E. 1, Pellegrino P. 1, Castoldi F. 2, Blonna D. 2
1 Università degli Studi di Torino, Torino, Italia;
2 Dipartimento di Ortopedia e Traumatologia, Ospedale Mauriziano “Umberto I”, Torino, Italia
Aim. The aim of this study is to identify whether the American Shoulder and Elbow Score (ASES) or the Oxford Shoulder Score (OSS) is most suitable for the follow-up of patients with shoulder disorders.
Methods. Twenty-nine patients with shoulder ailments (mean age 62, range 15-80) coming to our outpatients department for a first examination or for their follow-up were included in the study. These patients were asked to complete both ASES and OSS after two different orthopedic examinations carried out over a period of 1-4 weeks. No treatment or prescription was given during the first examination. Patients with shoulder instability or those unable to fill in the questionnaires on their own were excluded. The Bland-Altman analysis was used to evaluate the intraobserver reliability and the ANOVA two-way to measure the Intraclass Correlation Coefficient (ICC). The floor and ceiling effects and the Pearson’s correlation coefficient between the two questionnaires were also evaluated.
Results. Both the scores showed excellent reliability either dealing with ICC (ASES: 0.90; OSS: 0.89) or with systematic errors (ASES: 0 points; OSS: 0.2 points), but the 95% limits of agreement were respectively 23 (ASES) and 16 (OSS). Only the ASES was associated with a ceiling effect (28%) and a floor effect (3%). A strong correlation was found between the two scores (r=0.99; P<0.0001).
Conclusion. The OSS seems to be better than ASES because it is more sensitive, it has a lower dispersion of errors and it is not associated to a ceiling or floor effect.