Background
Methods
Search strategy
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The study focussed on patients suffering from shoulder complaints
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The association of at least one prognostic factor with the outcome of shoulder pain had to be presented
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The design had to be a cohort study
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The article was published in English
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Results were published as a full report before February 2014
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Studies that focused on shoulder pain due to luxation, cancer or systematic diseases such as rheumatoid arthritis or osteoporosis were excluded. Also studies that focused on the results of surgery were excluded.
Quality assessment
Criteria | Score | |
---|---|---|
Study population
| ||
A. | Inception cohort (defined in relationship to onset of symptoms) | +/−/? |
B. | Description of inclusion and exclusion | +/? |
C. | Description of study population | +/? |
Response
| ||
D. | Response >75 % | +/−/? |
E. | Information about non-responders versus responders | +/−/? |
Follow-up (extent and length)
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F. | Prospective data collection | +/−/? |
G. | Follow-up of at least 6 months | +/−/? |
H. | Drop-outs/loss to follow-up < 20 % | +/−/? |
I. | Information completers versus loss to follow-up/drop-outs | +/−/? |
Treatment
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J. | Treatment in cohort is fully described/standardised | +/−/? |
Outcome
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K. | Standardised assessment of relevant outcome criteria | +/? |
Prognostic factors
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L. | Standardised assessment of patient characteristics and potential clinical prognostic factor(s) | +/? |
M. | Standardised assessment of potential psychosocial prognostic factor(s) | +/? |
Data presentation
| ||
N. | Frequencies of most important outcome measures | +/− |
O. | Frequencies of most important prognostic factors | +/− |
P. | Appropriate analysis techniques | +/−/? |
Q. | Prognostic model is presented | +/−/? |
R. | Sufficient numbers | +/− |
Analysis
Level of evidence | |
---|---|
Strong | Consistent findings (>75 %) in at least two high quality cohorts |
Moderate | Consistent findings (>75 %) in one high quality cohort and at least one low quality cohort |
Weak | Findings of one high quality cohort or consistent findings (>75 %) in at least three or more low quality cohorts |
Inconclusive | Inconsistent findings irrespective of study quality, or less than three low quality cohorts available |
No evidence | No data presented |
Results
Selection of studies
Methodological quality
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | Quality score | Score (%) | ||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
First author | |||||||||||||||||||||
Bartolozzi | 1994 | - | + | - | ? | ? | + | + | - | ? | + | + | + | ? | + | + | + | - | + | 10 | 56 |
Binder | 1984 | - | + | - | ? | ? | + | + | + | ? | + | + | + | ? | + | + | - | - | - | 9 | 50 |
Brox | 1996 | - | + | + | + | - | ? | + | + | + | ? | + | + | + | + | + | + | + | + | 14 | 78 |
Cassou | 2002 | + | + | + | + | ? | + | + | + | ? | ? | + | + | + | + | + | + | + | + | 15 | 83 |
Chard | 1988 | + | ? | + | ? | ? | + | + | + | ? | ? | + | + | ? | + | + | + | ? | + | 11 | 61 |
Croft | 1996 | + | ? | + | ? | ? | + | + | - | + | ? | + | ? | ? | + | - | + | ? | + | 9 | 50 |
Engebretsen | 2010 | - | + | + | + | ? | + | + | + | + | + | + | + | + | + | + | + | + | - | 15 | 83 |
Gill | 2013 | - | ? | + | ? | ? | + | + | ? | ? | ? | + | + | - | + | + | - | + | + | 9 | 50 |
Herin | 2012 | - | ? | + | ? | ? | + | + | ? | ? | ? | + | + | + | + | + | - | + | + | 10 | 56 |
Kaergaard | 2000 | ? | ? | + | + | ? | + | + | - | - | ? | + | ? | + | - | - | ? | ? | - | 6 | 33 |
Kennedy | 2006 | + | + | + | + | + | + | - | + | ? | + | + | + | + | + | + | + | + | + | 16 | 89 |
Kuijpers | 2006 | + | + | + | ? | ? | + | + | + | + | + | + | + | + | + | + | + | + | + | 16 | 89 |
Kuroda | 2001 | ? | ? | + | ? | ? | + | + | ? | ? | ? | ? | ? | ? | + | - | ? | ? | + | 5 | 28 |
Luime | 2004 | - | ? | + | ? | ? | + | + | - | - | ? | + | + | + | + | + | + | + | - | 10 | 56 |
Macfarlane | 1998 | - | ? | + | + | ? | + | + | - | + | ? | + | + | + | + | + | + | + | + | 13 | 72 |
Miranda | 2001 | ? | ? | + | + | + | + | + | ? | ? | ? | + | + | + | + | - | + | + | + | 12 | 67 |
Morrison | 1997 | ? | + | - | ? | ? | + | + | + | ? | + | + | + | ? | + | + | - | - | + | 10 | 56 |
Mulcahy | 1994 | - | ? | + | ? | ? | + | - | - | ? | + | + | ? | ? | ? | - | - | - | - | 4 | 22 |
O’Malley | 2004 | ? | ? | + | ? | ? | + | - | - | + | + | + | + | + | + | + | + | + | - | 11 | 61 |
Shaffer | 1992 | - | + | + | ? | ? | + | + | - | ? | - | + | ? | ? | + | - | - | - | - | 6 | 33 |
Solomon | 2001 | - | + | + | ? | ? | + | + | ? | ? | ? | + | + | ? | - | + | + | + | - | 9 | 50 |
Thomas | 2004 | + | + | + | ? | ? | + | + | + | ? | + | + | + | ? | + | + | + | + | + | 14 | 78 |
Viikari | 2000 | + | ? | + | - | + | + | - | ? | ? | ? | + | ? | ? | + | + | + | + | + | 10 | 56 |
Windt | 1996 | + | + | + | + | - | + | + | + | - | - | + | + | ? | + | + | + | + | + | 14 | 78 |
Windt | 2007 | + | + | + | ? | ? | + | - | + | + | + | + | + | + | + | + | + | + | + | 15 | 83 |
Characteristics of studies
Evidence for prognostic factors
Prognostic factor assessed at baseline | Outcome | QS > 60 % | QS ≤ 60 % | Level of evidence |
---|---|---|---|---|
Primary care
| ||||
Poorer | 4/5 | ─ | Strong | |
Better | 1/5 | ─ | ||
Poorer | 3/3 | ─ | Strong | |
Poorer | 4/4 | 1/1 | Strong | |
Better | 1/2 | ─ | Inconclusive | |
No association | 1/2 | ─ | ||
Poorer | 2/4 | 1/1 | Inconclusive | |
No association | 2/4 | ─ | ||
Poorer | ─ | 1/1 | Inconclusive | |
No association | 2/2 | ─ | ||
Better | 1/5 | ─ | Inconclusive | |
Poorer | 1/5 | ─ | ||
No association | 3/5 | ─ | ||
Poorer | 2/4 | ─ | Inconclusive | |
No association | 2/4 | ─ | ||
Secondary care
| ||||
Poorer | 2/2 | 1/2 | Strong | |
Better | ─ | 1/2 | ||
Better | 2/2 | ─ | Strong | |
Better | 1/1 | 1/1 | Moderate | |
Poorer | ─ | 1/3 | Inconclusive | |
No association | ─ | 2/3 | ||
Poorer | ─ | 2/4 | Inconclusive | |
No association | 1/1 | 2/4 | ||
Better | ─ | 1/4 | Inconclusive | |
No association | ─ | 3/4 | ||
Poorer | ─ | 1/3 | Inconclusive | |
No association | 1/1 | 2/3 | ||
Poorer | ─ | 1/1 | Inconclusive | |
No association | 1/1 | ─ | ||
Better | 1/2 | ─ | Inconclusive | |
No association | 1/2 | ─ | ||
Occupational setting
| ||||
Poorer | ─ | 2/2 | Inconclusive | |
Poorer | 2/2 | 1/3 | Inconclusive | |
No association | 2/3 | |||
Better | ─ | 1/3 | Inconclusive | |
Poorer | ─ | 1/3 | ||
No association | 1/1 | 1/3 | ||
Poorer | 2/2 | ─ | Inconclusive | |
No association | ─ | 1/1 | ||
Poorer | 1/2 | 1/5 | Inconclusive | |
No association | 1/2 | 3/5 | ||
Better | ─ | 1/3 | Inconclusive | |
Poorer | 1/2 | ─ | ||
No association | 1/2 | 2/3 |
Prognostic factor assessed at baseline | Outcome | QS > 60 % | QS ≤ 60 % | Level of evidence |
---|---|---|---|---|
Primary care
| ||||
Poorer | ─ | 1/1 | Strong | |
No association | 3/3 | ─ | ||
Better | 1/5 | ─ | Strong | |
No association | 4/5 | ─ | ||
No association | 5/5 | ─ | Strong | |
No association | 2/2 | ─ | Strong | |
No association | 2/2 | ─ | Strong | |
No association | 2/2 | ─ | Strong | |
No association | 3/3 | ─ | Strong | |
No association | 2/2 | ─ | Strong | |
Secondary care
| ||||
No association | 2/2 | 5/5 | Strong | |
Poorer | ─ | 1/6 | Strong | |
No association | 2/2 | 5/6 | ||
No association | 2/2 | ─ | Strong | |
No association | 2/2 | ─ | Strong | |
No association | 2/2 | ─ | Strong | |
No association | 1/1 | 1/1 | Moderate | |
Occupational setting
| ||||
No association | 1/1 | 3/3 | Strong |