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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 4, 466-473.
doi: 10.1302/0301-620X.90B4.20290  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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The development and validation of a patient-reported questionnaire to assess outcomes of elbow surgery

J. Dawson, DPhil, Senior Research Scientist1; H. Doll, DPhil, Senior Medical Statistician1; I. Boller, BSc, Research Officer2; R. Fitzpatrick, PhD, Professor of Public Health1; C. Little, FRCS(Tr & Orth), Consultant Orthopaedic Surgeon3; J. Rees, MD, FRCS(Tr & Orth), University Lecturer in Orthopaedics and Honorary Consultant Orthopaedic Surgeon3; C. Jenkinson, DPhil, Professor of Health Services Research1; and A. J. Carr, FRCS, Nuffield Professor of Orthopaedic Surgery3

1 Department of Public Health University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
2 School of Health and Social Care Oxford Brookes University, Marston Road Campus, Jack Straws Lane, Oxford OX3 0FL, UK.
3 Nuffield Department of Orthopaedic Surgery Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7LD, UK.

Correspondence should be sent to Dr J. Dawson; e-mail: jill.dawson{at}dphpc.ox.ac.uk

We developed a questionnaire to assess patient-reported outcome after surgery of the elbow from interviews with patients. Initially, 17 possible items with five response options were included. A prospective study of 104 patients (107 elbow operations) was carried out to analyse the underlying factor structure, dimensionality, internal and test-retest reliability, construct validity and responsiveness of the questionnaire items. This was compared with the Mayo Elbow performance score clinical scale, the Disabilities of the Arm, Shoulder and Hand questionnaire, and the Short-Form (SF-36) General Health Survey. In total, five questions were considered inappropriate, which resulted in the final 12-item questionnaire, which has been referred to as the Oxford elbow score. This comprises three unidimensional domains, ‘elbow function’, ‘pain’ and ‘social-psychological’; with each domain comprising four items with good measurement properties.

This new 12-item Oxford elbow score is a valid measure of the outcome of surgery of the elbow.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General