The Single Assessment Numeric Evaluation (SANE)

What is the SANE?

The Single Assessment Numeric Evaluation (SANE) is a single-question outcome measure that asks patients to rate their function, as it pertains to the area being treated, on a scale of 0% (abnormal) to 100% (normal).

This tool can be used to assess a patient’s perception of their overall level of function relative to “normal”. Further, it can provide an opportunity to engage with the patient to illustrate functional progress over time, as well as discuss remaining challenges and opportunities for improvement. This may shine light on potential interventions that could be added to the patient’s plan of care, to facilitate functional restoration of the tasks discussed.

How is the SANE Scored?

The SANE is scored on a scale of 0-100%, with higher scores indicating greater function. The measure is set to be sent to the patient at a predetermined cadence over a 2 year period of time. The minimal clinically important difference (MCID) varies by patient population. In one study of both operative and non-operative shoulder patients, the MCID was shown to be 15%.1

The MCID is the smallest change that a patient would notice and appreciate, and can be used to determine whether they are responding to treatment. If the patient’s score on an outcome measure changes by more than the MCID, it is likely that they are benefiting from the established treatment.

However, MCID is merely the floor clinicians and patients should be aiming for, as many patients exceed MCID by a substantial margin. Patient-reported outcome specific goals should be aligned with optimizing each patient’s recovery, versus solely attaining the MCID.

How is the SANE Scored? (continued)

To best interpret results of patient-reported outcome measures and understand if your patient is making significant improvements, beneficial metrics other than the MCID should be referenced, such as the substantial clinical benefit (SCB). This value indicates the amount of change required for a patient to feel they significantly improved from an intervention. It is best practice to research your patient population for each case to determine if specific MCID or SCB values exist in the literature.

What is the Clinical Utility of the SANE?

The SANE has excellent acceptance in the literature for a variety of conditions and regions of injury. The measure has shown responsiveness similar to more comprehensive measures, and reduces survey fatigue and respondent burden with only one question.