Patient-reported outcome measures for non-specific neck pain validated in the Italian-language: a systematic review

Patient-reported outcome measures can improve the management of patients with non-specific neck pain. The choice of measure greatly depends on its content and psychometric properties. Most questionnaires were developed for English-speaking people, and need to undergo cross-cultural validation for use in different language contexts. To help Italian clinicians select the most appropriate tool, we systematically reviewed the validated Italian-language outcome measures for non-specific neck pain, and analyzed their psychometric properties and clinical utility.

The search was performed in MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, and Cochrane Library. All articles published in English or Italian regarding the development, translation, or validation of patient-reported outcome measures available in the Italian language were included. Two reviewers independently selected the studies, extracted data, and assessed methodological quality using the COSMIN checklist.

Out of 4891articles screened, 66 were eligible. Overall, they were of poor or fair methodological quality. Four instruments measuring function and disability (Neck Disability Index, Neck Pain and Disability Scale, Neck Bournemouth Questionnaire, and Core Outcome Measures Index), and one measuring activity-related fear of movement (NeckPix©) were identified. Each scale showed some psychometric weaknesses or problems with functioning, and none emerged as a gold standard.

Several patient-reported outcome measures are now available for assessing Italian people with non-specific neck pain. While the Neck Disability Index is the one most widely used, the Neck Bournemouth Questionnaire appears the most promising tool from a psychometric point of view.