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The diagnostic value of the combination of patient characteristics, history, and clinical shoulder tests for the diagnosis of rotator cuff tear

BACKGROUND: It is unknown which combination of patient information and clinical tests might be optimal for the diagnosis of rotator cuff tears. This study aimed to determine the diagnostic value of nine individual clinical tests for evaluating rotator cuff tear and to develop a prediction model for...

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Autores principales: van Kampen, Derk A, van den Berg, Tobias, van der Woude, Henk Jan, Castelein, Rene M, Scholtes, Vanessa AB, Terwee, Caroline B, Willems, W Jaap
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237868/
https://www.ncbi.nlm.nih.gov/pubmed/25099359
http://dx.doi.org/10.1186/s13018-014-0070-y
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author van Kampen, Derk A
van den Berg, Tobias
van der Woude, Henk Jan
Castelein, Rene M
Scholtes, Vanessa AB
Terwee, Caroline B
Willems, W Jaap
author_facet van Kampen, Derk A
van den Berg, Tobias
van der Woude, Henk Jan
Castelein, Rene M
Scholtes, Vanessa AB
Terwee, Caroline B
Willems, W Jaap
author_sort van Kampen, Derk A
collection PubMed
description BACKGROUND: It is unknown which combination of patient information and clinical tests might be optimal for the diagnosis of rotator cuff tears. This study aimed to determine the diagnostic value of nine individual clinical tests for evaluating rotator cuff tear and to develop a prediction model for diagnosing rotator cuff tear. METHODS: This prospective cohort study included 169 patients with shoulder complaints. Patients who reported a previous shoulder dislocation were excluded from the analysis (N = 69). One experienced clinician conducted 25 clinical tests of which 9 are specifically designed to diagnose rotator cuff pathology (empty can, Neer, Hawkins-Kenney, drop arm, lift-off test, painful arc, external rotation lag sign, drop sign, infraspinatus muscle strength test). The final diagnosis, based on magnetic resonance arthrography (MRA), was determined by consensus between the clinician and a radiologist, who were blinded to patient information. A prediction model was developed by logistic regression analysis. RESULTS AND DISCUSSION: In this cohort, 38 patients were diagnosed with rotator cuff tears. The individual overall accuracy of the rotator cuff clinical tests was 61%–75%. After backward selection, the model determined that the most important predictors of rotator cuff tears were higher age and a positive Neer test. This internally validated prediction model had good discriminative ability (area under the receiver operating characteristic curve (AUC) = 0.73). CONCLUSION: Our results showed that individual clinical shoulder tests had moderate diagnostic value for diagnosing rotator cuff tear. Our prediction model showed improved diagnostic value. However, the prediction value is still relatively low, supporting a low threshold for additional diagnostic tests for the diagnosis of rotator cuff tears. LEVEL OF EVIDENCE: Study of diagnostic test: level I.
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spelling pubmed-42378682014-11-21 The diagnostic value of the combination of patient characteristics, history, and clinical shoulder tests for the diagnosis of rotator cuff tear van Kampen, Derk A van den Berg, Tobias van der Woude, Henk Jan Castelein, Rene M Scholtes, Vanessa AB Terwee, Caroline B Willems, W Jaap J Orthop Surg Res Research Article BACKGROUND: It is unknown which combination of patient information and clinical tests might be optimal for the diagnosis of rotator cuff tears. This study aimed to determine the diagnostic value of nine individual clinical tests for evaluating rotator cuff tear and to develop a prediction model for diagnosing rotator cuff tear. METHODS: This prospective cohort study included 169 patients with shoulder complaints. Patients who reported a previous shoulder dislocation were excluded from the analysis (N = 69). One experienced clinician conducted 25 clinical tests of which 9 are specifically designed to diagnose rotator cuff pathology (empty can, Neer, Hawkins-Kenney, drop arm, lift-off test, painful arc, external rotation lag sign, drop sign, infraspinatus muscle strength test). The final diagnosis, based on magnetic resonance arthrography (MRA), was determined by consensus between the clinician and a radiologist, who were blinded to patient information. A prediction model was developed by logistic regression analysis. RESULTS AND DISCUSSION: In this cohort, 38 patients were diagnosed with rotator cuff tears. The individual overall accuracy of the rotator cuff clinical tests was 61%–75%. After backward selection, the model determined that the most important predictors of rotator cuff tears were higher age and a positive Neer test. This internally validated prediction model had good discriminative ability (area under the receiver operating characteristic curve (AUC) = 0.73). CONCLUSION: Our results showed that individual clinical shoulder tests had moderate diagnostic value for diagnosing rotator cuff tear. Our prediction model showed improved diagnostic value. However, the prediction value is still relatively low, supporting a low threshold for additional diagnostic tests for the diagnosis of rotator cuff tears. LEVEL OF EVIDENCE: Study of diagnostic test: level I. BioMed Central 2014-08-07 /pmc/articles/PMC4237868/ /pubmed/25099359 http://dx.doi.org/10.1186/s13018-014-0070-y Text en Copyright © 2014 Van Kampen et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
van Kampen, Derk A
van den Berg, Tobias
van der Woude, Henk Jan
Castelein, Rene M
Scholtes, Vanessa AB
Terwee, Caroline B
Willems, W Jaap
The diagnostic value of the combination of patient characteristics, history, and clinical shoulder tests for the diagnosis of rotator cuff tear
title The diagnostic value of the combination of patient characteristics, history, and clinical shoulder tests for the diagnosis of rotator cuff tear
title_full The diagnostic value of the combination of patient characteristics, history, and clinical shoulder tests for the diagnosis of rotator cuff tear
title_fullStr The diagnostic value of the combination of patient characteristics, history, and clinical shoulder tests for the diagnosis of rotator cuff tear
title_full_unstemmed The diagnostic value of the combination of patient characteristics, history, and clinical shoulder tests for the diagnosis of rotator cuff tear
title_short The diagnostic value of the combination of patient characteristics, history, and clinical shoulder tests for the diagnosis of rotator cuff tear
title_sort diagnostic value of the combination of patient characteristics, history, and clinical shoulder tests for the diagnosis of rotator cuff tear
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237868/
https://www.ncbi.nlm.nih.gov/pubmed/25099359
http://dx.doi.org/10.1186/s13018-014-0070-y
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