Predicting Recurrent Instability of the Shoulder (PRIS): A Valid Tool to Predict Which Patients Will Not Have Repeat Shoulder Instability After First-Time Traumatic Anterior Dislocation

J Orthop Sports Phys Ther. 2020 Aug;50(8):431-437. doi: 10.2519/jospt.2020.9284.

Abstract

Objective: To assess the sensitivity, specificity, and validity of the Predicting Recurrent Instability of the Shoulder (PRIS) tool in people with a first-time traumatic anterior shoulder dislocation.

Design: Prospective cohort study.

Methods: People with first-time traumatic anterior shoulder dislocation (n = 85), aged 16 to 40 years, were recruited within 12 weeks of their shoulder dislocation and followed prospectively for 1 year post injury. We calculated the sensitivity, specificity, negative predictive value, and positive predictive value of the PRIS tool.

Results: Of the 75 participants available for 1-year follow-up, 57 (76%) did not have recurrent shoulder instability. With the PRIS tool cut point set at 0.895, the tool's sensitivity was 39% (95% confidence interval [CI]: 17.3%, 64.3%) and its specificity was 95% (95% CI: 85.4%, 98.9%). The area under the curve was 0.69 (95% CI: 0.55, 0.84; P = .01). The PRIS tool correctly identified 54 of the 57 (95%) who did not have recurrent instability (accuracy, 81%; 95% CI: 70.7%, 89.4%). Negative and positive predictive values were 83% (95% CI: 77.2%, 87.7%) and 70% (95% CI: 40.2%, 89.0%), respectively.

Conclusion: The PRIS tool can predict those who will not have further shoulder instability in the year following first-time traumatic anterior shoulder dislocation. The PRIS tool cannot accurately predict those who will have recurrent shoulder instability. J Orthop Sports Phys Ther 2020;50(8):431-437. doi:10.2519/jospt.2020.9284.

Keywords: prognostic; recurrent shoulder instability; validation.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Instability / diagnosis*
  • Joint Instability / etiology
  • Joint Instability / therapy
  • Male
  • Prognosis
  • Prospective Studies
  • Recurrence
  • Risk Assessment / methods*
  • Sensitivity and Specificity
  • Shoulder Dislocation / diagnosis*
  • Shoulder Dislocation / etiology
  • Shoulder Dislocation / therapy
  • Young Adult