***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Study Design . Prospect i ve cohort study . Objective . To evaluate whether the DASH is not only a valid and responsive instrument to measure patients with shoulder , arm , and h and complaints , but also to evaluate patients with neck complaints . Summary of Background Data . The DASH has shown to be a valid and responsive question naire to evaluate disability in patients with shoulder , arm , and h and complaints . However , patients with shoulder , arm , or h and complaints frequently report neck complaints as well . Therefore , a valid and responsive question naire design ed for the whole upper extremity , including the neck , would be very useful and practical in upper-extremity research . Methods . Six hundred seventy-nine patients visiting their general practitioner with a new episode of nontraumatic complaints of the neck and upper extremity were evaluated by use of question naires at baseline and at 6-months follow-up . Six (sub)groups were formulated according to the location of complaints , including a subgroup with complaints in the shoulder-arm-h and region only and a group with complaints of the neck only . Disability ( DASH ) , general health [ SF-12 ( physical and mental component ) ] , severity , and persistence of complaints were assessed . Construct validity , floor and ceiling effects , and responsiveness were studied . Results . Correlations between the DASH  and the other measures within the 6 (sub)groups at baseline ( construct validity ) , for the change scores at 6-months follow-up ( responsiveness ) , and the responsiveness ratios were classified as acceptable . No floor and ceiling effects were found . Conclusion . The DASH performed well with regard to the a priori hypotheses . This study has shown acceptable validity and responsiveness of the DASH for use in patients with nontraumatic neck complaints in addition to shoulder , arm , and h and complaints . We would caution against using the DASH in patients with neck complaints only , since fewer of the hypotheses could be confirmed in this subgroup Study Design . An observational prospect i ve cohort study in general practice . Objectives . To describe the clinical course and to identify predictors of recovery , changes in pain intensity , and changes in functional disability in patients with neck or shoulder symptoms at 3- and 12-month follow-up . Summary of Background Data . Knowledge on the clinical course and predictors of outcome in neck and shoulder symptoms is limited . Such knowledge would facilitate treatment decisions and may help to inform patients about their prognosis . Methods . Four hundred and forty-three patients who consulted their general practitioner with neck or shoulder symptoms participated in the study . Baseline scores of pain and disability , symptom characteristics , sociodemographic and psychological factors , social support , physical activity , general health , and comorbidity were investigated as possible predictors of recovery , changes in pain intensity , and changes in functional disability using multiple regression analyses . Results . The recovery rate was low ; 24 % of the patients reported recovery at 3 months and 32 % reported recovery at 12-month follow-up . Duration of the symptoms before consulting the GP and a history of neck or shoulder symptoms increased the probability of an unfavorable outcome . Furthermore , less vitality and more worrying were consistently associated with poorer outcome after 3 and 12 months . The area under the receiver-operator characteristic curve for the model predicting recovery was 0.8 at 3 months and 0.75 at 12 months . The explained variance of the models on pain and functional disability ranged from 43 to 54 % . Conclusions . The results found in this study indicate that besides clinical characteristics , psychological factors also predict the outcome of neck and shoulder symptoms Objectives For the measurement of  patient-reported outcomes , such as ( health-related ) quality of life , often many measurement instruments exist that intend to measure the same construct . To facilitate instrument selection , our aim was to develop a highly sensitive search filter for finding studies on measurement properties of measurement instruments in PubMed and a more precise search filter that needs less abstract s to be screened , but at a higher risk of missing relevant studies . Methods A r and om sample of 10,000 PubMed records ( 01 - 01 - 1990 to 31 - 12 - 2006 ) was used as a gold st and ard . Studies on measurement properties were identified using an exclusion filter and h and search ing . Search terms were selected from the relevant records in the gold st and ard as well as from 100 systematic review s of measurement properties and combined based on sensitivity and precision . The performance of the filters was tested in the gold st and ard as well as in two validation sets , by calculating sensitivity , precision , specificity , and number needed to read . Results We identified 116 studies on measurement properties in the gold st and ard . The sensitive search filter was able to retrieve 113 of these 116 studies ( sensitivity 97.4 % , precision 4.4 % ) . The precise search filter had a sensitivity of 93.1 % and a precision of 9.4 % . Both filters performed very well in the validation sets . Conclusion The use of these search filters will contribute to evidence -based selection of measurement instruments in all medical fields OBJECTIVE To determine the prevalence , interrelation , and impact of musculoskeletal disorders of the upper limb in the general population . METHODS A total of 9,696 r and omly selected adults of working age were surveyed in a 2-stage cross-sectional study involving a screening question naire and a st and ardized physical examination in symptomatic subjects . Age- and sex-specific prevalence rates were estimated for several musculoskeletal disorders and for nonspecific pain in the upper limbs . The overlap and impact on daily activities and healthcare utilization were explored . RESULTS Among 6,038 first-stage responders , 3,152 reported upper limb symptoms and 1,960 were subsequently examined . Of subjects with pain , 44.8 % had 1 or more specific soft-tissue disorders . Site-specific prevalence rates were as follows : shoulder tendinitis 4.5 % among men and 6.1 % among women ; adhesive capsulitis 8.2 % among men and 10.1 % among women ; lateral epicondylitis 1.3 % among men and 1.1 % among women ; de Quervain 's disease 0.5 % among men and 1.3 % among women ; other tenosynovitis of the h and or wrist , 1.1 % among men and 2.2 % among women . Specific disorders tended to cluster ( P < 0.001 ) in individuals , with particular overlap at the shoulder . Compared with subjects with nonspecific pain , those with specific disorders more often reported inability to perform everyday tasks ( P < 0.05 ) , consultation with a doctor ( P < 0.05 ) , and use of prescribed medication ( P < 0.05 ) . CONCLUSION Upper limb pain is common in the general population and is often associated with physical signs suggestive of specific upper-limb disorders . These disorders have a substantial impact on physical function and use of health care Background : Epidemiological research in the field of soft tissue neck and upper limb disorders has been hampered by the lack of an agreed system of diagnostic classification . In 1997 , a United Kingdom workshop agreed consensus definitions for nine of these conditions . From these criteria , an examination schedule was developed and vali date d in a hospital setting . Objective : To investigate the reliability of this schedule in the general population . Methods : Ninety seven adults of working age reporting recent neck or upper limb symptoms were invited to attend for clinical examination consisting of inspection and palpation of the upper limbs , measurement of active and passive ranges of motion , and clinical provocation tests . A doctor and a trained research nurse examined each patient separately , in r and om order and blinded to each other 's findings . Results : Between observer repeatability of the schedule was generally good , with a median κ coefficient of 0.66 ( range 0.21 to 0.93 ) for each of the specific diagnoses considered . Conclusion : As expected , the repeatability of tests is poorer in the general population than in the hospital clinic , but the Southampton examination schedule is sufficiently reproducible for epidemiological research in the general population Study Design . A prospect i ve , multicenter , cross-sectional analysis of data from the National Spine Network data base . Objectives . To compare the relative impact of radicular and axial symptoms associated with disease of the cervical spine on general health as measured by the SF-36 Health Survey , and to compare the impact of these symptoms among patients of varying age and symptom duration . Background . Degenerative disorders of the cervical spine can cause debilitating symptoms of neck and arm pain . Physicians generally treat radiculopathy more aggressively than axial neck pain alone , although it has never been shown that the presence of radiculopathy leads to a greater impairment of physical and mental function . Material s and Methods . SF-36 Health Survey data were collected from all consenting patients seen within the National Spine Network . Patients with symptoms referable to the cervical spine ( as per their physician ) were included ( n = 1,809 ) .  SF-36 scores for all eight scales ( bodily pain ( BP ) , vitality ( VT ) , general health ( GH ) , mental health ( MH ) , physical function ( PF ) , role physical ( RP ) , role emotional ( RE ) , and social function ( SF ) , and two summary scales ( Physical Component Summary [ PCS ] and Mental Component Summary [ MCS ] ) were calculated . Age/gender normative scores were subtracted from the scale scores to produce a negative “ impact ” score , which reflected how far below normal health status these patients were . Patients were grouped according to location of symptoms ( axial only , radicular only , or axial and radicular ) , age ( younger than 40 , 40 to 60 , and older than 60 years ) , and symptom duration ( acute : < 6 wk ; subacute : 6 wk–6 mo ; and chronic : > 6 mo ) . SF-36 scores were compared between all groups using analysis of variance and multiple comparisons with Bonferroni adjustment . Results . Patients who presented with both axial and radicular symptoms had the lowest SF-36 scores relative to age and gender norms . These scores were significantly lower than those for patients with only axial or only radicular symptoms across all eight subscales ( P < 0.05–P < 0.0001 ) . Scores for patients with only axial pain were significantly lower than for patients with only radicular pain for VT ( P < 0.04 ) and GH ( P < 0.004 ) . Patients younger than 40 and those between ages 40 to 60 years were significantly more impacted by their symptoms than patients older than 60 years for all eight scales ( P < 0.01 ) . PCS scores were similar for acute , subacute , and chronic groups , whereas MCS scores were significantly worse for patients with chronic pain . Conclusions . Combined neck and arm pain were much more disabling than either symptom alone . Younger patients ( younger than 40 or 40–60 ) were more affected by these symptoms than patients older than 60 years . In addition , as symptom duration increased , a negative impact on mental health was observed , although chronic symptoms did not affect physical health . This study suggests that patients with a significant component of axial pain in conjunction with cervical radiculopathy should be considered the most affected of all patients with cervical spondylosis . Given the evidence that the treatment methods at the disposal of physicians are effective , this study suggests that prompt treatment of these patients may help avoid the harmful effects of chronic symptoms on mental functioning , especially among younger patients who were found to be more impacted by the symptoms 
    Output:
    
The findings of this study will assist clinicians who seek to utilise suitable and accurate measures to assess upper limb function for a patient with neck pain .