Margit Kooijman

Prognostic factors | 79 Characteristics of studies Study characteristics are presented in Appendix B. Eight studies were conducted in a primary care setting; ten in a secondary care setting and seven in an occupational setting. In total, 60 potential prognostic factors were evaluated. Pain, duration of symptoms, disability, age, gender and psychological factors were reported on most often. In all new studies, through multivariable analysis, an attempt was made to determine a set of prognostic factors with the highest prognostic value. Many studies conducted their analyses on more than one or on a combined outcome measure. This resulted in a wide variety of outcome measures including pain, disability, range of movement, patient perceived recovery, shoulder instability, recovery and several shoulder questionnaires combining these measures. Evidence for prognostic factors A best evidence synthesis was performed to summarize prognostic factors of shoulder disorders. This included the results of the previous systematic review on this topic by Kuijpers et al. (2004) 8 . In Table 4, prognostic factors studied at least twice and their relationship with outcome are presented. It shows that there is strong evidence that higher shoulder pain intensity, concomitant neck pain and a longer duration of symptoms predict poorer outcome in primary care settings. In secondary care populations, strong evidence was found for the association between greater disability and poorer outcome and between the existence of previous shoulder pain and poorer outcome. In this population there is moderate evidence that higher education is associated with better outcome.