Patient self-report section of the ASES questionnaire: a Spanish validation study using classical test theory and the Rasch model

doi:10.1186/s12955-016-0552-1

. 2016 Oct 18;14(1):147.

doi: 10.1186/s12955-016-0552-1.

Patient self-report section of the ASES questionnaire: a Spanish validation study using classical test theory and the Rasch model

Kalliopi Vrotsou^{1

2

3}, Ricardo Cuéllar⁴, Félix Silió⁵, Miguel Ángel Rodriguez⁶, Daniel Garay⁷, Gorka Busto⁸, Ziortza Trancho⁹, Antonio Escobar^{10

9}

Affiliations

¹ Unidad de Investigación de Atención Primaria-OSIS de Gipuzkoa, Instituto Biodonostia, Paseo Dr. Begiristain s/n, 20014, San Sebastián, Spain. KALLIOPI.VROTSOUKANARI@osakidetza.net.
² Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain. KALLIOPI.VROTSOUKANARI@osakidetza.net.
³ Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain. KALLIOPI.VROTSOUKANARI@osakidetza.net.
⁴ Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Donostia, San Sebastián, Spain.
⁵ Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Basurto, Bilbao, Spain.
⁶ Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Cruces, Barakaldo, Spain.
⁷ Servicio de Traumatología y Cirugía Ortopédica, Hospital Galdakao-Usansolo, Galdakao, Spain.
⁸ Servicio de Traumatología y Cirugía Ortopédica, Hospital de Mendaro, Mendaro, Spain.
⁹ Unidad de Investigación, Hospital Universitario Basurto, Bilbao, Spain.
¹⁰ Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain.

PMID: 27756317
PMCID: PMC5070228
DOI: 10.1186/s12955-016-0552-1

Patient self-report section of the ASES questionnaire: a Spanish validation study using classical test theory and the Rasch model

Kalliopi Vrotsou et al. Health Qual Life Outcomes. 2016.

. 2016 Oct 18;14(1):147.

doi: 10.1186/s12955-016-0552-1.

Authors

Kalliopi Vrotsou^{1

2

3}, Ricardo Cuéllar⁴, Félix Silió⁵, Miguel Ángel Rodriguez⁶, Daniel Garay⁷, Gorka Busto⁸, Ziortza Trancho⁹, Antonio Escobar^{10

9}

Affiliations

¹ Unidad de Investigación de Atención Primaria-OSIS de Gipuzkoa, Instituto Biodonostia, Paseo Dr. Begiristain s/n, 20014, San Sebastián, Spain. KALLIOPI.VROTSOUKANARI@osakidetza.net.
² Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain. KALLIOPI.VROTSOUKANARI@osakidetza.net.
³ Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain. KALLIOPI.VROTSOUKANARI@osakidetza.net.
⁴ Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Donostia, San Sebastián, Spain.
⁵ Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Basurto, Bilbao, Spain.
⁶ Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Cruces, Barakaldo, Spain.
⁷ Servicio de Traumatología y Cirugía Ortopédica, Hospital Galdakao-Usansolo, Galdakao, Spain.
⁸ Servicio de Traumatología y Cirugía Ortopédica, Hospital de Mendaro, Mendaro, Spain.
⁹ Unidad de Investigación, Hospital Universitario Basurto, Bilbao, Spain.
¹⁰ Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain.

PMID: 27756317
PMCID: PMC5070228
DOI: 10.1186/s12955-016-0552-1

Abstract

Background: The aim of the current study was to validate the self-report section of the American Shoulder and Elbow Surgeons questionnaire (ASES-p) into Spanish.

Methods: Shoulder pathology patients were recruited and followed up to 6 months post treatment. The ASES-p, Constant, SF-36 and Barthel scales were filled-in pre and post treatment. Reliability was tested with Cronbach's alpha, convergent validity with Spearman's correlations coefficients. Confirmatory factor analysis (CFA) and the Rasch model were implemented for assessing structural validity and unidimensionality of the scale. Models with and without the pain item were considered. Responsiveness to change was explored via standardised effect sizes.

Results: Results were acceptable for both tested models. Cronbach's alpha was 0.91, total scale correlations with Constant and physical SF-36 dimensions were >0.50. Factor loadings for CFA were >0.40. The Rasch model confirmed unidimensionality of the scale, even though item 10 "do usual sport" was suggested as non-informative. Finally, patients with improved post treatment shoulder function and those receiving surgery had higher standardised effect sizes.

Conclusions: The adapted Spanish ASES-p version is a valid and reliable tool for shoulder evaluation and its unidimensionality is supported by the data.

Keywords: ASES-p; Confirmatory factor analysis; Constant Murley Score; Rasch model; Responsiveness; SF-36; Shoulder; Spanish validation; Validity.

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Figures

**Fig. 1**
Flowchart of baseline and follow-up ASES-p received replies

**Fig. 2**
Standardized response means of the ASES-p total, function and pain scores, according received treatment. SRM: standardized response mean. Values below each treatment group (n = …) indicate number of valid replies for total scale, function and pain subscale scores respectively

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References

1. Juel NG, Natvig B. Shoulder diagnoses in secondary care, a one year cohort. BMC Musculoskelet Disord. 2014;15:89. doi: 10.1186/1471-2474-15-89. - DOI - PMC - PubMed
1. M.T.Vicente-Herrero, L.Capdevilla Garcia, A.A.Lopez Gonzalez, M.V.Ramiraz Iñiguez de la Torre, editors. El hombro y sus patologías en medicina del trabajo. In: SEMERGEN, vol 35. 2009. p. 197–202.
1. Michener LA, Leggin BG. A review of self-report scales for the assessment of functional limitation and disability of the shoulder. J Hand Ther. 2001;14:68–76. doi: 10.1016/S0894-1130(01)80036-3. - DOI - PubMed
1. Largacha M, Parsons IM, Campbell B, Titelman RM, Smith KL, Matsen F., III Deficits in shoulder function and general health associated with sixteen common shoulder diagnoses: a study of 2674 patients. J Shoulder Elbow Surg. 2006;15:30–9. doi: 10.1016/j.jse.2005.04.006. - DOI - PubMed
1. Kuijpers T, van der Windt DA, van der Heijden GJ, Twisk JW, Vergouwe Y, Bouter LM. A prediction rule for shoulder pain related sick leave: a prospective cohort study. BMC Musculoskeletal Disorders. 2006;7:97. doi: 10.1186/1471-2474-7-97. - DOI - PMC - PubMed

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[1] Juel NG, Natvig B. Shoulder diagnoses in secondary care, a one year cohort. BMC Musculoskelet Disord. 2014;15:89. doi: 10.1186/1471-2474-15-89. - DOI - PMC - PubMed

[2] Juel NG, Natvig B. Shoulder diagnoses in secondary care, a one year cohort. BMC Musculoskelet Disord. 2014;15:89. doi: 10.1186/1471-2474-15-89. - DOI - PMC - PubMed

[3] M.T.Vicente-Herrero, L.Capdevilla Garcia, A.A.Lopez Gonzalez, M.V.Ramiraz Iñiguez de la Torre, editors. El hombro y sus patologías en medicina del trabajo. In: SEMERGEN, vol 35. 2009. p. 197–202.

[4] M.T.Vicente-Herrero, L.Capdevilla Garcia, A.A.Lopez Gonzalez, M.V.Ramiraz Iñiguez de la Torre, editors. El hombro y sus patologías en medicina del trabajo. In: SEMERGEN, vol 35. 2009. p. 197–202.

[5] Michener LA, Leggin BG. A review of self-report scales for the assessment of functional limitation and disability of the shoulder. J Hand Ther. 2001;14:68–76. doi: 10.1016/S0894-1130(01)80036-3. - DOI - PubMed

[6] Michener LA, Leggin BG. A review of self-report scales for the assessment of functional limitation and disability of the shoulder. J Hand Ther. 2001;14:68–76. doi: 10.1016/S0894-1130(01)80036-3. - DOI - PubMed

[7] Largacha M, Parsons IM, Campbell B, Titelman RM, Smith KL, Matsen F., III Deficits in shoulder function and general health associated with sixteen common shoulder diagnoses: a study of 2674 patients. J Shoulder Elbow Surg. 2006;15:30–9. doi: 10.1016/j.jse.2005.04.006. - DOI - PubMed

[8] Largacha M, Parsons IM, Campbell B, Titelman RM, Smith KL, Matsen F., III Deficits in shoulder function and general health associated with sixteen common shoulder diagnoses: a study of 2674 patients. J Shoulder Elbow Surg. 2006;15:30–9. doi: 10.1016/j.jse.2005.04.006. - DOI - PubMed

[9] Kuijpers T, van der Windt DA, van der Heijden GJ, Twisk JW, Vergouwe Y, Bouter LM. A prediction rule for shoulder pain related sick leave: a prospective cohort study. BMC Musculoskeletal Disorders. 2006;7:97. doi: 10.1186/1471-2474-7-97. - DOI - PMC - PubMed

[10] Kuijpers T, van der Windt DA, van der Heijden GJ, Twisk JW, Vergouwe Y, Bouter LM. A prediction rule for shoulder pain related sick leave: a prospective cohort study. BMC Musculoskeletal Disorders. 2006;7:97. doi: 10.1186/1471-2474-7-97. - DOI - PMC - PubMed

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Patient self-report section of the ASES questionnaire: a Spanish validation study using classical test theory and the Rasch model

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Patient self-report section of the ASES questionnaire: a Spanish validation study using classical test theory and the Rasch model

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