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BACKGROUND
To generate an item list for the assessment of joint awareness in shoulder patients and to collect patient feedback on the comprehensibility of the items and the forgotten joint concept.

METHODS
Item content was generated on the basis of literature search and expert ratings following a stepwise refinement procedure, including final evaluation by an international expert board (n = 12) including members with various professional backgrounds. Items were translated from English to German and evaluated in 30 German-speaking shoulder patients in Switzerland and 30 shoulder patients in the UK.

RESULTS
Literature search identified 45 questionnaires covering 805 issues potentially relevant for the assessment of joint awareness. Stepwise item selection resulted in 97 items to be evaluated by the international expert board leaving 70 items for collecting patient feedback. The majority of patients indicated that the introductory text explaining the forgotten joint concept was easy or very easy to understand (79.3%) and that the items were clear (91.4%).

CONCLUSION
We developed a list of 70 questions for the assessment of joint awareness in shoulder patients and obtained positive patient feedback for these. In a next step, we will administer the items to a large international patient sample to obtain data for psychometric analysis and development of a measurement model, which is the basis for creation of computer-adaptive assessments or static short-forms.