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. 1998 Feb;57(2):82–87. doi: 10.1136/ard.57.2.82

The responsiveness of the Shoulder Disability Questionnaire

D A W M van der Windt 1, G J M G van der Heijden 1, A F de Winter 1, B Koes 1, W Deville 1, L Bouter 1
PMCID: PMC1752535  PMID: 9613336

Abstract

Objective—To evaluate the responsiveness of the Shoulder Disability Questionnaire (SDQ).
Methods—The study was conducted within the framework of an observational study on shoulder disorders in primary care. After first presentation of their complaints to the general practitioner and after one and six months, participants completed the SDQ, a single question on functional status (FSQ), and an ordinal 11 point scale for the severity of pain (PSS). Responsiveness of the SDQ was evaluated compared with that of the FSQ and PSS, by calculating responsiveness ratios and by plotting receiver operating characteristic (ROC) curves. Recovery according to the patient was used as an external criterion for clinically relevant improvement (complete recovery or much improved on a six point Likert scale was denoted as clinically relevant improvement).
Results—A total of 349 consecutive patients with shoulder disorders were enrolled in the observational study. Response rates ranged between 96% and 89%. Responsiveness ratios were slightly higher for the PSS compared with the SDQ (2.53 versus 2.22 at one month, 2.24 versus 1.89 at six months). The area under the ROC curve was 0.84 for both the SDQ and the PSS, and 0.72 for the FSQ.
Conclusion—The results of this study confirm the responsiveness of the SDQ, making it a useful instrument to assess functional disability in longitudinal studies.

 Keywords: shoulder; outcome assessment; functional disability; responsiveness

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Figure 1  .

Figure 1  

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Receiver operator characteristic (ROC) curves for ΔSDQ (Shoulder Disability Questionnaire, ΔPSS (Pain Severity Scale) and ΔFSQ (Functional Status Question) at one month. True positive rate (sensitivity) and false positive rate (100-specificity) are for discriminating between patients reporting clinical improvement or clinical stability. Potential cut off points for the SDQ: ΔSDQ = 18.75: sensitivity 74%, specificity 77% (optimal trade off); ΔSDQ = 40: (mean change in clinically improved patients) sensitivity 46%, specificity 98%.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Badley E. M., Tennant A. Changing profile of joint disorders with age: findings from a postal survey of the population of Calderdale, West Yorkshire, United Kingdom. Ann Rheum Dis. 1992 Mar;51(3):366–371. doi: 10.1136/ard.51.3.366. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bassey E. J., Morgan K., Dallosso H. M., Ebrahim S. B. Flexibility of the shoulder joint measured as range of abduction in a large representative sample of men and women over 65 years of age. Eur J Appl Physiol Occup Physiol. 1989;58(4):353–360. doi: 10.1007/BF00643509. [DOI] [PubMed] [Google Scholar]
  3. Beaton D. E., Richards R. R. Measuring function of the shoulder. A cross-sectional comparison of five questionnaires. J Bone Joint Surg Am. 1996 Jun;78(6):882–890. doi: 10.2106/00004623-199606000-00011. [DOI] [PubMed] [Google Scholar]
  4. Binder A. I., Bulgen D. Y., Hazleman B. L., Roberts S. Frozen shoulder: a long-term prospective study. Ann Rheum Dis. 1984 Jun;43(3):361–364. doi: 10.1136/ard.43.3.361. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bjelle A. Epidemiology of shoulder problems. Baillieres Clin Rheumatol. 1989 Dec;3(3):437–451. doi: 10.1016/s0950-3579(89)80003-2. [DOI] [PubMed] [Google Scholar]
  6. Chakravarty K., Webley M. Shoulder joint movement and its relationship to disability in the elderly. J Rheumatol. 1993 Aug;20(8):1359–1361. [PubMed] [Google Scholar]
  7. Chard M. D., Hazleman R., Hazleman B. L., King R. H., Reiss B. B. Shoulder disorders in the elderly: a community survey. Arthritis Rheum. 1991 Jun;34(6):766–769. doi: 10.1002/art.1780340619. [DOI] [PubMed] [Google Scholar]
  8. Chard M. D., Sattelle L. M., Hazleman B. L. The long-term outcome of rotator cuff tendinitis--a review study. Br J Rheumatol. 1988 Oct;27(5):385–389. doi: 10.1093/rheumatology/27.5.385. [DOI] [PubMed] [Google Scholar]
  9. Croft P., Pope D., Zonca M., O'Neill T., Silman A. Measurement of shoulder related disability: results of a validation study. Ann Rheum Dis. 1994 Aug;53(8):525–528. doi: 10.1136/ard.53.8.525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Cunningham D. A., Paterson D. H., Himann J. E., Rechnitzer P. A. Determinants of independence in the elderly. Can J Appl Physiol. 1993 Sep;18(3):243–254. doi: 10.1139/h93-021. [DOI] [PubMed] [Google Scholar]
  11. Deyo R. A., Centor R. M. Assessing the responsiveness of functional scales to clinical change: an analogy to diagnostic test performance. J Chronic Dis. 1986;39(11):897–906. doi: 10.1016/0021-9681(86)90038-x. [DOI] [PubMed] [Google Scholar]
  12. Downing D. S., Weinstein A. Ultrasound therapy of subacromial bursitis. A double blind trial. Phys Ther. 1986 Feb;66(2):194–199. doi: 10.1093/ptj/66.2.194. [DOI] [PubMed] [Google Scholar]
  13. Guyatt G. H., Bombardier C., Tugwell P. X. Measuring disease-specific quality of life in clinical trials. CMAJ. 1986 Apr 15;134(8):889–895. [PMC free article] [PubMed] [Google Scholar]
  14. Guyatt G. H., Kirshner B., Jaeschke R. Measuring health status: what are the necessary measurement properties? J Clin Epidemiol. 1992 Dec;45(12):1341–1345. doi: 10.1016/0895-4356(92)90194-r. [DOI] [PubMed] [Google Scholar]
  15. Guyatt G., Walter S., Norman G. Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis. 1987;40(2):171–178. doi: 10.1016/0021-9681(87)90069-5. [DOI] [PubMed] [Google Scholar]
  16. Hanley J. A., McNeil B. J. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982 Apr;143(1):29–36. doi: 10.1148/radiology.143.1.7063747. [DOI] [PubMed] [Google Scholar]
  17. Liang M. H. Evaluating measurement responsiveness. J Rheumatol. 1995 Jun;22(6):1191–1192. [PubMed] [Google Scholar]
  18. Nykänen M. Pulsed ultrasound treatment of the painful shoulder a randomized, double-blind, placebo-controlled study. Scand J Rehabil Med. 1995 Jun;27(2):105–108. [PubMed] [Google Scholar]
  19. Reeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol. 1975;4(4):193–196. doi: 10.3109/03009747509165255. [DOI] [PubMed] [Google Scholar]
  20. Roach K. E., Budiman-Mak E., Songsiridej N., Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991 Dec;4(4):143–149. [PubMed] [Google Scholar]
  21. Stucki G., Liang M. H., Fossel A. H., Katz J. N. Relative responsiveness of condition-specific and generic health status measures in degenerative lumbar spinal stenosis. J Clin Epidemiol. 1995 Nov;48(11):1369–1378. doi: 10.1016/0895-4356(95)00054-2. [DOI] [PubMed] [Google Scholar]
  22. Van der Schouw Y. T., Verbeek A. L., Ruijs J. H. ROC curves for the initial assessment of new diagnostic tests. Fam Pract. 1992 Dec;9(4):506–511. doi: 10.1093/fampra/9.4.506. [DOI] [PubMed] [Google Scholar]
  23. Vecchio P. C., Kavanagh R. T., Hazleman B. L., King R. H. Community survey of shoulder disorders in the elderly to assess the natural history and effects of treatment. Ann Rheum Dis. 1995 Feb;54(2):152–154. doi: 10.1136/ard.54.2.152. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Williams J. W., Jr, Holleman D. R., Jr, Simel D. L. Measuring shoulder function with the Shoulder Pain and Disability Index. J Rheumatol. 1995 Apr;22(4):727–732. [PubMed] [Google Scholar]
  25. van der Heijden G. J., van der Windt D. A., Kleijnen J., Koes B. W., Bouter L. M. Steroid injections for shoulder disorders: a systematic review of randomized clinical trials. Br J Gen Pract. 1996 May;46(406):309–316. [PMC free article] [PubMed] [Google Scholar]
  26. van der Windt D. A., Koes B. W., Boeke A. J., Devillé W., De Jong B. A., Bouter L. M. Shoulder disorders in general practice: prognostic indicators of outcome. Br J Gen Pract. 1996 Sep;46(410):519–523. [PMC free article] [PubMed] [Google Scholar]
  27. van der Windt D. A., Koes B. W., de Jong B. A., Bouter L. M. Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis. 1995 Dec;54(12):959–964. doi: 10.1136/ard.54.12.959. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. van der Windt D. A., van der Heijden G. J., Scholten R. J., Koes B. W., Bouter L. M. The efficacy of non-steroidal anti-inflammatory drugs (NSAIDS) for shoulder complaints. A systematic review. J Clin Epidemiol. 1995 May;48(5):691–704. doi: 10.1016/0895-4356(94)00170-u. [DOI] [PubMed] [Google Scholar]

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