Patient-Rated Elbow Evaluation Most Responsive Instrument

Comparison of five assessment tools shows PREE best identifies changes pre-, post-arthroplasty

MONDAY, June 18 (HealthDay News) -- The Patient-Rated Elbow Evaluation form (PREE) is the most responsive instrument to identify and quantify elbow joint-specific changes before and after total elbow arthroplasty, according to a study published online June 5 in Arthritis Care & Research.

Felix Angst, M.D., M.P.H., from the Schulthess Klinik in Zurich, and colleagues prospectively compared five elbow-joint outcome instruments for their sensitivity to change in a prospective cohort of 65 patients who underwent total elbow arthroplasty. Outcome was assessed using the Short Form 36 (SF-36); the Disability of the Arm, Shoulder, and Hand questionnaire (DASH); the modified American Shoulder and Elbow Surgeons questionnaire for the elbow patient part (pmASES) and examiner/clinical part (cmASES); and the PREE. The effect size (ES) was used to quantify responsiveness before and six months after total elbow arthroplasty.

The researchers found that, in the total scores, the ES of the PREE was 1.50; the pmASES was 1.32; the cmASES was 0.86; the DASH was 0.56; and the SF-36 was 0.11, with all changes significant, except cmASES-DASH. Within the subdomains of pain/symptoms and function the same order was noted, and the order remained consistent using standardized response mean and receiver operating response curves. The best discrimination between "much better" and the other categories was seen for PREE total, DASH function, and pmASES total and pain.

"The PREE was the most responsive instrument and can be recommended for every set of measures for elbow joint disorders," the authors write.

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