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Abstract
The purpose of this study was to conduct a systematic review of the psychometric evidence
relating to Constant-Murley score.
A search of 3 databases (Medline, CINAHL, and EMBASE) and a manual search yielded
35 relevant publications. Pairs of raters used structured tools to analyze these articles,
through critical appraisal and data extraction. A descriptive synthesis of the psychometric
evidence was then performed.
Quality ratings of 23% of the studies reviewed reached a level of 75% or higher. Studies
evaluating the content validity of the Constant-Murley score suggest that the description
in the original publication is insufficient to accomplish standardization between
centers and evaluators. Despite this limitation, the Constant-Murley score correlates
strongly (>or= 0.70) with shoulder-specific questionnaires, reaches acceptable benchmarks
(rho > 0.80) for its reliability coefficients, and is responsive (effect sizes and
standardized response mean > 0.80) for detecting improvement after intervention in
a variety of shoulder pathologies.
This systematic review provides evidence to support the use of the Constant-Murley
score for specific clinical and research applications but underscores the need for
greater standardization and precaution when interpreting scores. Methods to improve
standardization and measurement precision are needed. Responsiveness has been shown
to be excellent, but some properties still need be evaluated, particularly those related
to the absolute errors of measurement and minimal clinically important difference.
Given the widespread acceptance for usage of the Constant-Murley score in clinical
studies and early indications that the measure is responsive, studies defining more
rigid standardization of the tools/procedures are needed.
Level 1.