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Related Experiment Videos

Defining the minimum level of detectable change for the Roland-Morris questionnaire

P W Stratford1, J Binkley, P Solomon

  • 1School of Rehabilitation Science, McMaster University, Ontario, Canada.

Physical Therapy
|April 1, 1996
PubMed
Summary

The Roland-Morris Questionnaire (RMQ) can detect changes in low back pain disability for individuals with scores between 4 and 20. However, it may not reliably detect changes for those with very low or very high initial scores.

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Area of Science:

  • Rehabilitation medicine
  • Clinical measurement
  • Low back pain research

Background:

  • The Roland-Morris Questionnaire (RMQ) is a validated measure for low back pain disability.
  • Its reliability and sensitivity to change in groups are established.
  • Its utility for individual patient decision-making is less understood.

Purpose of the Study:

  • To determine the minimum level of detectable change (MLDC) for the RMQ in individual patients.
  • To assess the RMQ's responsiveness to change at the individual level.

Main Methods:

  • 60 outpatients with low back pain were enrolled.
  • The RMQ was administered at baseline and 4-6 weeks later.
  • Conditional standard errors of measurement (CSEMs) were calculated to estimate MLDC.

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Main Results:

  • The minimum level of detectable change at 90% confidence was 4-5 RMQ points.
  • CSEMs were small enough to detect change in patients with scores from 4 to 20.
  • CSEMs were too large to detect improvement in patients scoring below 4 or deterioration in patients scoring above 20.

Conclusions:

  • The RMQ's ability to detect change varies depending on the patient's initial score.
  • The instrument is most effective for detecting changes in patients with moderate disability levels.
  • Clinical interpretation of RMQ scores should consider the potential for measurement error at the extremes of the scale.