Different answering scales used within the Constant-Murley Score are not interchangeable
ESSKA Academy. Hollman F. Nov 8, 2019; 284405; epESA-09 Topic: Shoulder
Freek Hollman
Freek Hollman
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Different answering scales used within the Constant-Murley Score are not interchangeable

ePoster - epESA-09

Topic: Basic Science and Biomechanics

Hollman F., de Raadt W.M., Wolterbeek N., Auw Yang K.G.
St. Antonius Hospital, Orthopaedic Surgery, Utrecht, Netherlands

Introduction: Multiple versions of the Constant-Murley score (CMS) exist with varying answering scales. The question arises whether the different versions of the CMS can be used interchangeably and if results of studies using different versions are comparable. The purpose of this study was to assess the interchangeability of various existing answering scales within the subjective part of the CMS.
Objectives: It was hypothesizedthat the different answering scales of pain, daily work and recreational activity of the CMS were interchangeable and would not influence the total score significantly. In addition, it was expected the inter- and intra-observer measurement of the different answering scales were reliable and comparable.
Aims: The primary objective was to determine the interchangeability of different versions of the CMS for shoulder pathology. Secondly, to determine the inter- and intra-observer reliability of the different answering scales.
Methods: This study concerned a prospective, cross-sectional trial. Patients older than 18 years of age with shoulder problems were eligible for this study.Six versions of the CMS were prepared with different orders of the answering scales for the measures of pain, occupational ability and recreational activity (verbal and paper based visual analogue scale (VAS), smiley face, numeric rating scale (NRS)). The internal consistency (Cronbrach's alpha) of the various CMS were assessed.Spearman correlation coefficients were calculated to examine the convergent validity. In addition, the intra-observer and inter-observer agreement was assessed (intraclass and interclass correlation coefficients (ICC)).
Results: A total of 93 patients were included. The total scores of the paper based VAS, smiley face score and NRS were 46.9 ± 19.4, 45.2 ± 18.5 and 45.0 ± 18.7 (Cronbach's α range 0.76-0.79) respectively. Correlations of the total CMS scores of the different versions varied from 0.98 to 0.99. CMS-category versus CMS-smiley face score and CMS-category versus CMS-NRS pain were significantly different, P=0.02 and P=0.01, respectively. The total CMS score did not change significantly. Acceptable inter- and intra-observer reliability was found (ICC: 0.89-0.97, 0.98-0.99; P< 0.001).
Conclusions: The different answering options for the CMS subscales pain, occupational ability and recreational activity were not interchangeable. However, with excellent inter- and intra-observer reliability, the total scores were interchangeable.
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