Key facts
- Score direction
- Higher is better
- Meaningful change
- For general shoulder populations (excluding shoulder instability - see sane-instability), Thigpen et al. (2018) reported a minimal clinically important difference (MCID) of approximately 15 percentage points, a minimal detectable change (MDC) of 7 to 9 percentage points, and a standard error of measurement (SEM) of approximately 3.4.
- Scoring
- Patients provide a single percentage (0 to 100) in answer to "How would you rate your shoulder today as a percentage of normal?", where 100% is a completely normal shoulder and 0% is the worst possible shoulder. The scor…
About the SANE (Single Assessment Numeric Evaluation) - Shoulder
SANE is a single-question patient-reported outcome measure originally described by Williams et al. (1999) as a quick alternative to multi-item shoulder rating scales. Patients give one number from 0 to 100 summarising how normal their shoulder feels, with no fixed sub-domains for pain or function. It is widely used alongside, or instead of, longer measures such as the Oxford Shoulder Score or ASES because it takes seconds to complete.
Medical Specialties
Anatomic Areas
Clinical Indications
Developer Information
Originally described by Glenn N. Williams and colleagues at the United States Military Academy and Keller Army Community Hospital as a brief alternative to longer shoulder outcome questionnaires.
Origin
Built on Patient Watch - an open-source community form. It is not validated or endorsed by any copyright holder.
Administration Instructions
Rate your shoulder as a percentage of normal, where 100% is a completely normal shoulder.
Scoring Methodology
Patients provide a single percentage (0 to 100) in answer to "How would you rate your shoulder today as a percentage of normal?", where 100% is a completely normal shoulder and 0% is the worst possible shoulder. The score is the value given - no calculation is applied.
Meaningful Change Threshold
For general shoulder populations (excluding shoulder instability - see sane-instability), Thigpen et al. (2018) reported a minimal clinically important difference (MCID) of approximately 15 percentage points, a minimal detectable change (MDC) of 7 to 9 percentage points, and a standard error of measurement (SEM) of approximately 3.4.
Score Interpretation
Understanding what your score means
poor
0 - 49Shoulder rated well below normal, with substantial perceived impairment
fair
50 - 69Shoulder rated moderately below normal
good
70 - 89Shoulder rated close to normal, with mild residual impairment
normal
90 - 100Shoulder rated as normal or near-normal
Clinical Limitations & Considerations
As a single-item global rating, SANE does not distinguish pain from function, or identify which activities are affected - unlike multi-item measures such as the Oxford Shoulder Score. Patient understanding of what counts as "normal" can vary. The published MCID/MDC values exclude shoulder instability patients; use the SANE for Instability wording and its own thresholds for that population.
Supporting Literature
Key validation and development studies for the SANE (Single Assessment Numeric Evaluation) - Shoulder
- 1
Comparison of the Single Assessment Numeric Evaluation method and two shoulder rating scales. Outcomes measures after shoulder surgery
Williams GN, Gangel TJ, Arciero RA, Uhorchak JM, Taylor DC
The American Journal of Sports Medicine, 1999
- 2
Validity and Responsiveness of the Single Alpha-numeric Evaluation for Shoulder Patients
Thigpen CA, Shanley E, Momaya AM, Kissenberth MJ, Tolan SJ, Tokish JM, Hawkins RJ
The American Journal of Sports Medicine, 2018
Used in Literature
Studies and publications that have used the SANE (Single Assessment Numeric Evaluation) - Shoulder
- 1
Comparison of the Single Assessment Numeric Evaluation method and two shoulder rating scales. Outcomes measures after shoulder surgery
Williams GN, Gangel TJ, Arciero RA, Uhorchak JM, Taylor DC
The American Journal of Sports Medicine, 1999
Frequently asked questions
What does a fair SANE (Single Assessment Numeric Evaluation) - Shoulder score mean?
A SANE (Single Assessment Numeric Evaluation) - Shoulder score of 50 to 69 is classified as fair. Shoulder rated moderately below normal
What does a good SANE (Single Assessment Numeric Evaluation) - Shoulder score mean?
A SANE (Single Assessment Numeric Evaluation) - Shoulder score of 70 to 89 is classified as good. Shoulder rated close to normal, with mild residual impairment
What does a poor SANE (Single Assessment Numeric Evaluation) - Shoulder score mean?
A SANE (Single Assessment Numeric Evaluation) - Shoulder score of 0 to 49 is classified as poor. Shoulder rated well below normal, with substantial perceived impairment
What does a normal SANE (Single Assessment Numeric Evaluation) - Shoulder score mean?
A SANE (Single Assessment Numeric Evaluation) - Shoulder score of 90 to 100 is classified as normal. Shoulder rated as normal or near-normal
Related Outcome Measures
Other clinical questionnaires for similar specialties and conditions
SANE for Instability - Shoulder
A single patient-reported outcome question asking patients with shoulder instability to rate their shoulder as a percentage, where 100% represents a completely stable shoulder.
Oxford Shoulder Score
A concise questionnaire evaluating shoulder-related pain and functional ability in patients undergoing shoulder surgery (excluding stabilisation).
Oxford Shoulder Instability Score
A 12-item patient-reported outcome measure evaluating pain, function and the psychological impact of shoulder instability (recurrent dislocation or subluxation), for use before and after surgical or non-surgical treatment.
QuickDASH
The Disabilities of the Arm, Shoulder and Hand (QuickDASH) Outcome Measure
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