16-Sep-98 4:00 PM CST

Self-assessment of general health status in patients with five common shoulder conditions

Author: Gary M. Gartsman, MD, Mark R. Brinker, MD, Myrna Khan, MS, and Mustafa Karahan, MD, Houston, TX, and Istanbul, Turkey

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As on increasing number of medical procedures compete for 0 decreasing number of health core dollars, interest is focusing on both the cost and effectiveness of medical care. Although expenditures can be quantified, it is harder to evaluate the effectiveness of a particular medical treatment or operative procedure. Traditional reporting in orthopaedics has focused on measuring the process of care, Process measures include such factors as range of motion, strength, and component loosening (as determined by radiographic appearance), Recently, emphasis has been placed on patient· based outcome analysis. Patient·based outcomes are assessments that measure the results of care as they are perceived by patients, They include factors like pain, function, satisfaction, and quality of life, This type of analysis has been termed outcome research.

Patient outcome studies in orthopaedics that use the tools of outcome research may be thought of as having two basic components, one measuring patient function for a disorder of a particular body part or anatomic region (condition-specific measures) and the other measuring a patient's general health status Igeneric health status measures). Examples of instruments measuring a particular anatomic region include the hip (Harris Hip Score6). the knee (Hungerford Knee Score7 ), and the shoulder (University of California Los Angeles Shoulder Scoring System). Current efforts have been placed on constructing validated (those that have been studied and shown to truly measure who! they are intended to measure) instruments such as the Johanson rating for the hip,' the Constant shoulder function scoring system, and the carpal tunnel syndrome evaluation by Levine at 01. 12 General health status measures such as the Sickness Index Profile' and the SF·36 Health Survey take into account various qualitative and quantitative facets of a person's life and do not refer to the specific disease or problem that is causing compromised health. Such measures of health can be quantified and may be a means by which various musculoskeletal conditions can be evaluated and campared with each other. These measures may allow the comparison 01 conditions in one branch of medicine with those in another medical specialty...

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