Core Outcome Measure Index for low back patients: do we miss anxiety and depression?

Area of Science:

• Pain Management
• Psychometrics
• Rehabilitation Medicine

Background:

• The Core Outcome Measure Index (COMI) is a standard tool for low back pain (LBP) but lacks psychological dimensions.
• A biopsychosocial approach is crucial for a comprehensive understanding of LBP patients.

Purpose of the Study:

• To evaluate the psychometric properties of a modified COMI (COMIAD) incorporating anxiety and depression items.
• To assess if adding psychological measures impacts the original COMI's validity and reliability.

Main Methods:

• A multicenter prospective cohort study involving 168 LBP patients.
• Patients completed COMIAD and validated full-length anxiety/depression questionnaires pre- and post-treatment.
• Construct validity, internal consistency, reproducibility, and clinical impact were analyzed.

Main Results:

• The added anxiety and depression items demonstrated good internal consistency and reproducibility.
• High correlations were found between COMIAD items and corresponding full-length scales.
• The COMIAD showed no floor/ceiling effects and minimally impacted the original COMI's psychometric properties.

Conclusions:

• The COMIAD's anxiety and depression items possess strong psychometric qualities.
• The modified COMIAD integrates psychological assessment without compromising the original questionnaire's utility.
• COMIAD provides a more holistic evaluation of LBP patients by including psychological dimensions.