University of California Los Angeles Shoulder Score (UCLA Shoulder Score)
The University of California at Los Angeles Shoulder Score (UCLA Shoulder Score) is one of the oldest shoulder outcomes measures in use today. It was published in 1981 with the purpose of being used in studies for patients with shoulder arthritis undergoing a total shoulder arthroplasty.
The UCLA outcome measure was developed at a time when little information was available on the appropriate methodology for instrument development. It was also a time when modern psychometric development was not routinely used. Consequently, the methodology used for the development of this measure is not explained and the reasoning behind the question development and its weighting is not understood. Despite this, the UCLA outcome measure is still used for specific situations such as following treatment for rotator cuff disease or shoulder instability.
The questionnaire is a combined objective and subjective survey and requires completion by both the doctor and patient. It has five subscales made up of active forward elevation, strength (physician reported), pain, satisfaction and function (patient reported). A maximum score of 35 is possible with higher scores indicating better outcomes. The UCLA score can then be converted to a 100-point scale for comparison with other shoulder outcome measures.
Although the UCLA measure has not been validated, it can be used to assess a variety of shoulder conditions including total shoulder arthroplasty, rotator cuff repair and subacromial decompression. Completion of the survey is also relatively quick and easy for patients.
As one of the first reporting measures of its kind, unfortunately there are few publications available with respect to its development or testing. Additionally, it is also unknown why the developers assigned various weights to the five (5) domains. Although this is not necessarily incorrect, it has thus far been unsupported.
Another consideration is that the pain and function domains are “double barreled.” For example, with regards to the pain scale, options are presented as a coupled response (frequency of pain + analgesia required). This leaves respondents with some difficulty picking an appropriate answer if they agree with half of the response (the frequency of the pain) but disagree with the other half (analgesia required).
The UCLA PROM reliability, validity and responsiveness is poorly established compared to other outcome measures.
Overall, the UCLA shoulder scoring measure may be useful for specific situations such as rotator cuff disease or shoulder instability, but researchers planning clinical trials should select a more modern instrument that has been developed with appropriate patient input and established validity and reliability.
The UCLA Shoulder Score does not require a license. To view the measure, please visit: www.orthopaedicscore.com/scorepages/ucla_shoulder_score.html.
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