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The cross-sectional construct validity of the Waddell score
Adri T Apeldoorn1, Raymond W Ostelo, Julie M Fritz
1Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands. a.apeldoorn@vumc.nl
The Clinical Journal of Pain
|September 20, 2011
Summary
The Waddell score shows satisfactory construct validity for assessing illness behavior in low back pain patients. However, it is not a reliable psychological screener and its associations with different domains are weak.
Area of Science:
- Pain Management
- Psychosomatic Medicine
- Clinical Assessment
Background:
- The Waddell score, developed in 1980, assesses non-organic signs in low back pain patients.
- Debate exists on its validity for screening illness behavior and psychological distress versus reflecting pain and physical function.
Purpose of the Study:
- To examine the construct validity of the Waddell score.
Main Methods:
- A cross-sectional study tested 20 a priori hypotheses on Waddell score associations.
- Hypotheses were based on a Medline search (1980-2010).
- Data from 229 chronic low back pain patients in outpatient rehabilitation were analyzed.
Main Results:
- 100% of hypotheses confirmed for pain domain, 80% for physical, 80% for illness behavior, and 50% for psychological domain.
- Correlation coefficients and kappa values ranged from 0.06 to 0.44.
- The Waddell score demonstrated satisfactory cross-sectional construct validity.
Conclusions:
- The Waddell score has satisfactory construct validity but does not pinpoint specific problems.
- Its associations with different domains are weak.
- It cannot be considered a straightforward psychological screener.
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