Development and Initial Validation of Patient-reported Lumbar Surgery Quality of Life (LSQoL): A Mixed Methods...

A mixed-methods study.

To develop and perform the initial validation of the Lumbar Surgery Quality of Life (LSQoL), a multidimensional patient-reported outcome measure for patients with lumbar degenerative diseases.

Patient-reported outcome measures (PROMs) are widely used to evaluate outcomes in lumbar degenerative diseases but are often applied in combination, with each instrument capturing only specific aspects of patient status. Consequently, improvement in traditional measures such as the Oswestry Disability Index (ODI) does not always correspond to patient-perceived recovery or satisfaction, highlighting the need for multidimensional tools that better reflect patient experience.

The LSQoL was developed using a multistage mixed-method approach, including literature review, patient interviews, expert consensus through the Delphi method, and weighting via the Analytic Hierarchy Process (AHP). The instrument was validated in 1,996 patients with lumbar degenerative diseases. Internal consistency, test-retest reliability, construct validity, and correlations with established PROMs and patient-reported recovery and satisfaction were evaluated.

The LSQoL consists of 21 items across five dimensions: pain, neurological function, activities of daily living, emotional status, and working ability. Internal consistency was acceptable to good (Cronbach's α: 0.744-0.805), and test-retest reliability was strong (ICC: 0.759-0.906). Factor analyses supported a stable multidimensional structure. The LSQoL demonstrated moderate correlations with established PROMs and stronger correlations with patient-reported recovery and satisfaction.

The LSQoL is a reliable and valid PROM that provides a comprehensive assessment of quality of life in patients with lumbar degenerative diseases. It is suitable for evaluating patient-reported outcomes both before and after lumbar surgery.