Bone and Joint Institute

The Patient-Rated Elbow Evaluation and the American Shoulder and Elbow Surgeons —Elbow form capture aspects of functioning that are important to patients with elbow injuries

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Journal of Hand Therapy

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© 2020 Hanley & Belfus Study Design: This is a cross-sectional study. Introduction: The Patient-Rated Elbow Evaluation (PREE) and the self-report section of the American Shoulder Elbow Surgeons–elbow form (pASES-e) are two important elbow-specific self-report measures used in routine clinical practice. Purpose of the Study: To use the International Classification of Functioning Disability and Health (ICF) to link aspects of functioning that are reported using the Patient-Specific Functional Scale by a cohort of patients with elbow disorders and compare it to the content of the PREE and the pASES-e. Methods: One hundred patients with a variety of elbow disorders (mean age and SD 53.88 (14.51); M: F 48: 52) were recruited from the Roth-McFarlane Hand and Upper Limb Centre. They self-reported important aspects of functioning using the Patient-Specific Functional Scale. These concerns were linked to the ICF using formal linking procedures. These ICF categories were compared to the categories related to the PREE and the pASES-e. Linking was carried out by two independent raters, and agreement was calculated using percentage agreement. Results: A total of 423 self-reported functional activities were linked to 25 second-level ICF categories from the activity and participation domain. Commonly reported activities were D640 doing housework (52%); D540 dressing (47%); and D475 driving (35%). PREE had better coverage of the patient concerns (71%) than pASES-e (50%). D475–driving (35%) and D440–fine hand use (24%) were the 2 major categories that were not captured by the questionnaires. Agreement between the raters was 90.5%. Discussion: This study established that the PREE and the pASES-e were able to capture aspects of functioning important to patients and that align with the ICF, with this happening to a greater extent on the PREE than the pASES-e. Because all patients reported concerns from the activity and participation section (‘d’ categories) of the ICF, this validated that these PROMs measure this conceptual domain. Conclusion: The PREE provided more comprehensive coverage of patients' functional concerns than the pASES-e.

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