Outcome Measures for Low Back Pain Research
- 1 September 1998
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Spine
- Vol. 23 (18), 2003-2013
- https://doi.org/10.1097/00007632-199809150-00018
Abstract
An international group of back pain researchers considered recommendations for standardized measures in clinical outcomes research in patients with back pain. To promote more standardization of outcome measurement in clinical trials and other types of outcomes research, including meta-analyses, cost-effectiveness analyses, and multicenter studies. Better standardization of outcome measurement would facilitate comparison of results among studies, and more complete reporting of relevant outcomes. Because back pain is rarely fatal or completely cured, outcome assessment is complex and involves multiple dimensions. These include symptoms, function, general well-being, work disability, and satisfaction with care. The panel considered several factors in recommending a standard battery of outcome measures. These included reliability, validity, responsiveness, and practicality of the measures. In addition, compatibility with widely used and promoted batteries such as the American Academy of Orthopaedic Surgeons Lumbar Cluster were considered to minimize the need for changes when these instruments are used. First, a six-item set was proposed, which is sufficiently brief that it could be used in routine care settings for quality improvement and for research purposes. An expanded outcome set, which would provide more precise measurement for research purposes, includes measures of severity and frequency of symptoms, either the Roland or the Oswestry Disability Scale, either the SF-12 or the EuroQol measure of general health status, a question about satisfaction with symptoms, three types of "disability days," and an optional single item on overall satisfaction with medical care. Standardized measurement of outcomes would facilitate scientific advances in clinical care. A short, 6-item questionnaire and a somewhat expanded, more precise battery of questionnaires can be recommended. Although many considerations support such recommendations, more data on responsiveness and the minimally important change in scores are needed for most of the instruments.This publication has 14 references indexed in Scilit:
- Evaluating changes in health status: Reliability and responsiveness of five generic health status measures in workers with musculoskeletal disordersJournal of Clinical Epidemiology, 1997
- Predicting Poor Outcomes for Back Pain Seen in Primary Care Using Patientsʼ Own CriteriaSpine, 1996
- The Maine Lumbar Spine Study, Part IISpine, 1996
- The North American Spine Society Lumbar Spine Outcome Assessment InstrumentSpine, 1996
- Outcome Measures for Studying Patients with Low Back PainSpine, 1994
- EuroQol - a new facility for the measurement of health-related quality of lifeHealth Policy, 1990
- A comparison of Likert and visual analogue scales for measuring change in functionJournal of Chronic Diseases, 1987
- Assessing the responsiveness of functional scales to clinical change: An analogy to diagnostic test performanceJournal of Chronic Diseases, 1986
- Comparative Validity of the Sickness Impact Profile and Shorter Scales for Functional Assessment in Low-Back PainSpine, 1986
- The Effects of Questionnaire Design on the Determination of End Results in Lumbar Spinal SurgerySpine, 1985