Reliability and Validity of a pictorial version of the Oxford Shoulder Score
Keywords:
Pictorial, PROM (patient reported outcome measure), shoulder function, Oxford Shoulder Score (OSS).Abstract
Background: Patient reported outcome measures assist in assessing surgical outcomes. Most African countries have a high illiteracy rate. The aim of this study was to develop and validate a pictorial version of the Oxford Shoulder Score (OSS) against the English OSS and Simple Shoulder Test (SST). Methods: A pictorial version of the OSS was developed. There were 12 questions, each modelled on the English OSS. Wong Baker faces were used as a scoring scale. The pictorial score was validated on patients who had shoulder pathology excluding instability at a tertiary center in South Africa between May 2016 and November 2017. Participants were first asked to complete the Pictorial OSS and then the English OSS and SST. Results: 87 participants completed the scores. The pictorial score was internally consistent with a Cronbach’s alpha of 0.95(CI 0.93-0.97). The Spearman Rank correlation coefficient was 0.8. The mean time required to complete the score, used as a surrogate marker of understanding, was 134s (STD 67s) which is less than the time taken to complete the English OSS or SST. Conclusion: The pictorial version of the OSS was reliable, reproducible, valid and acceptable, and can therefore be used in our patient population.
