Minimal important change of the Western Ontario Osteoarthritis of the Shoulder (WOOS) index in patients with glenohumeral osteoarthritis and rotator cuff tear arthropathy

Abstract

Introduction

The Minimal Important Change (MIC) for patient-reported outcome measures is the value that describes the smallest improvement considered worthwhile by patients. To the best of our knowledge, no MIC of the Western Ontario Osteoarthritis of the Shoulder Index (WOOS) score or the Disabilities of the Arm Shoulder and Hand (DASH) has been reported using the anchor-based predictive modeling approach based on patients with glenohumeral osteoarthritis or rotator cuff tear arthropathy. The aim of this study was to determine the MIC for WOOS and DASH in a cohort of patients with glenohumeral osteoarthritis or rotator cuff tear arthropathy treated with a total shoulder arthroplasty.

Materials and methods

Data on 231 patients were collected at four hospitals in Denmark and Finland. Data were collected at baseline and 12 weeks after surgery. At 12 weeks, the patients were asked about their perceived overall improvement after surgery measured by the Patient Global Impression of Change (PGI-C). The MIC was estimated for the WOOS and DASH using the adjusted predictive modeling approach with the PGI-C as an anchor.

Results

Of the 231 included patients, 104 were included in the MIC analysis. Patients had a mean age of 71 years and 56% were women. The estimated adjusted MIC for the WOOS score was 13.3 (-6.2; 23.3) and 7.2 (12.8; 1.7) for DASH.

Conclusion

For patients with glenohumeral osteoarthritis or rotator cuff tear arthropathy treated with a total shoulder arthroplasty, the estimated MIC for was 13.3 for WOOS and 7.2 for DASH. The estimates show wide confidence intervals, which could be due to the low sample size but could also indicate a large heterogeneity within the patient group.