Impact of symptom bilaterality and hand dominance on patient-reported disability outcomes
Bibliographic record
Abstract
OBJECTIVES: It is not clear if using patients with bilateral symptoms would impact the level of disability reported in orthopaedic research. The purposes of this study were to (1) examine the prevalence of bilateral shoulder symptoms (significant pain, stiffness or weakness affecting function) in patients with rotator cuff impingement syndrome, rotator cuff tear and osteoarthritis of the glenohumeral joint, (2) explore risk factors associated with bilateral shoulder symptoms, and (3) examine the impact of symptom bilaterality and hand dominance on pre- and post-operative patient-oriented disability outcomes. METHODS: This study involved secondary analysis of prospectively collected data of patients who had undergone shoulder surgery and had returned for their 1-year follow-up. Two outcome measures were collected prior to surgery and at 1-year following surgery: the American Shoulder and Elbow Surgeons and the Constant-Murley Score. RESULTS: Data of 772 patients, 376 (49%) females, 396 males (51%); 288 (impingement syndrome), 332 (rotator cuff tear), and 152 (osteoarthritis) were included in the analysis. There was a statistically significant difference in the prevalence of bilateral symptoms being 44%, 28%, and 22% in the osteoarthritis, impingement syndrome, and rotator cuff tear groups, respectively (p < 0.0001). The prevalence of dominant side involvement was 71%, 67%, and 53% in the rotator cuff tear, impingement syndrome, and osteoarthritis groups (p < 0.0001). Older age and female sex were risk factors for development of bilateral symptoms only in patients with rotator cuff tear. Neither symptom bilaterality nor dominant arm involvement had a negative impact on patient-oriented disability outcome measures prior to or after surgery (p > 0.05). CONCLUSION: This study shows that patients with osteoarthritis of the glenohumeral joint have the highest prevalence of bilateral shoulder complaints. The older age and the female sex increased the risk of having bilateral symptoms in patients with rotator cuff tear. Having bilateral shoulder symptoms or dominant side involvement was not associated with higher level of disability prior or after surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".