Related Experiment Videos
Assessing change over time in patients with low back pain
P W Stratford1, J Binkley, P Solomon
1School of Occupational Therapy and Physiotherapy, McMaster University, Hamilton, Ontario, Canada.
Physical Therapy
|June 1, 1994
Summary
The Roland-Morris (RM) questionnaire is best for tracking changes in low back pain over time, outperforming Oswestry (OSW) and Jan van Breemen Institute (JVB) questionnaires in sensitivity.
Area of Science:
- Rehabilitation Medicine
- Clinical Measurement
- Low Back Pain Research
Background:
- Assessing treatment effectiveness in mechanical low back pain relies on valid outcome measures.
- Several patient-reported outcome measures (PROMs) exist, including the Roland-Morris (RM), Oswestry (OSW), and Jan van Breemen Institute (JVB) questionnaires.
- Understanding the comparative ability of these PROMs to detect change is crucial for clinical practice and research.
Purpose of the Study:
- To compare the sensitivity to change of the RM, OSW, and JVB pain and function questionnaires.
- To evaluate the performance of these instruments in a cohort of patients with mechanical low back pain undergoing physical therapy.
Main Methods:
- Eighty-eight patients with mechanical low back pain completed the RM, OSW, and JVB questionnaires at baseline and 4-6 weeks later.
- Clinically important change was established through independent ratings by patients and clinicians.
- Receiver operating characteristic (ROC) curve analysis was employed to assess the sensitivity of each questionnaire to detect change.
Main Results:
- The ROC curve areas indicated that the RM (0.79), OSW (0.78), and JVB pain (0.79) questionnaires demonstrated significantly higher sensitivity to change compared to the JVB function questionnaire (0.66).
- Data completeness issues were noted: approximately 20% of OSW and 14% of JVB questionnaires had missing or multiple responses.
- A small percentage (3%) of RM questionnaires contained written words instead of checkmarks.
Conclusions:
- The Roland-Morris (RM) questionnaire demonstrated comparable, and in some aspects superior, ability to detect change over time in patients with low back pain.
- While OSW and JVB pain questionnaires also showed good sensitivity, the RM's performance and potentially simpler response format suggest it may be a preferred choice.
- Further research could explore optimizing data collection methods for all PROMs to minimize response errors.