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Spine

CLINIMETRIC REVIEW OF OUTCOMES QUESTIONNAIRES FOR LOW BACK PAIN/FOLLOWING LUMBAR SPINE SURGERY

Britspine, British Scoliosis Society (BSS), Society for Back Pain Research (SBPR), British Association of Spine Surgeons (BASS)



Abstract

Healthcare interventions are under increasing scrutiny regarding cost-effectiveness and outcome measures have revolutionised clinical research.

To identify all available outcome questionnaires designed for lowback, lumbar spine pathologies and to perform qualitative analysis of these questionnaires for their clinimetric properties.

A comprehensive e-search on PUBMED & EMBASE for all available outcome measures and published review articles for lowback and lumbar spine pathologies was undertaken over a two month period (Nov-Dec 2009). Twenty-eight questionnaires were identified in total. These outcomes questionnaires were evaluated for clinimetric properties viz:-

Validity (content, construct & criterion validity)

Reliability (internal consistency & reproducibility)

Responsiveness and scored on a scale of 0-6 points.

Eight outcomes questionnaires had satisfied all clinimetric domains in methodological evaluation (score 6/6).

Oswestry disability index (ODI)

Roland-Morris disability questionnaire (RMDQ)

Aberdeen lowback pain scale

Extended Aberdeen spine pain scale

Functional rating index

Core lowback pain outcome measure

Backpain functional scale

Maine-Seattle back questionnaire.

Sixteen of these questionnaires scored =5 when evaluated for clinimetric domains. RMDQ had the highest number of published and validated translations followed by ODI. Criterion validity was not tested for NASS-AAOS lumbar spine questionnaire.

32%(9/28) of the outcome instruments have undergone methodological evaluation for =3 clinimetric properties. Clinicians should be cautious when choosing appropriate validated outcome measures when evaluating therapeutic/surgical intervention. We suggest use of few validated outcome measures with high clinimetric scores (=5/6) to be made mandatory when reporting clinical results.