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Diagnostic accuracy of the Self-administered, Self-reported History Questionnaire for lumbar spinal stenosis patients in Japanese primary care settings: a multicenter cross-sectional study (DISTO-project)

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Diagnostic support tools for lumbar spinal stenosis such as the Self-administered, Self-reported History Questionnaire have been developed in Japan, but no report has demonstrated the diagnostic accuracy of this questionnaire in Japanese primary care settings. This multicenter, cross-sectional survey was performed to evaluate and improve the diagnostic accuracy of this questionnaire for lumbar spinal stenosis patients in Japanese primary care settings.

Methods

The lumbar spinal stenosis diagnosis support tool project was conducted in 1657 hospitals to evaluate the diagnostic accuracy of the Self-administered, Self-reported History Questionnaire in Japan from 2011 to 2012. Consecutive adults (≥50 years old) from physicians, including non-orthopedic general practitioners and orthopedic general practitioners, were considered for enrollment. Consecutive adults (≥50 years old) with low back pain from hospital-based orthopedic surgeons were also considered for enrollment. The diagnostic accuracy of the Self-administered, Self-reported History Questionnaire with initial and several new cutoff points in classifying patients according to the presence of lumbar spinal stenosis was assessed in terms of sensitivity, specificity and negative predictive values.

Results

Among the 33,545 patients, 10,199 (30.4 %) were diagnosed with lumbar spinal stenosis by the physicians. The Self-administered, Self-reported History Questionnaire version 1.1 with a new cutoff point was more sensitive than the Self-administered, Self-reported History Questionnaire version 1.0 with the initial cutoff point (79.8 vs. 68.3 %) and less specific (68.8 vs. 75.1 %) for lumbar spinal stenosis diagnosis. The respective negative predictive values were 88.5 and 84.3 %.

Conclusions

The Self-administered, Self-reported History Questionnaire version 1.1 with the new cutoff was more sensitive and had higher negative predictive value than version 1.0 with the initial cutoff. Therefore, the improved Self-administered, Self-reported History Questionnaire version 1.1 can be used for lumbar spinal stenosis screening, and its use may improve the quality of lumbar spinal stenosis diagnostic practice in Japanese primary care settings.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

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Corresponding author

Correspondence to Kinshi Kato.

Additional information

For the DISTO-project working group.

Members of the research groups are listed in the Appendix.

Appendix

Appendix

Lumbar Spinal Stenosis Diagnosis Support Tool (DISTO)-project group.

Chairman: Shin-ichi Kikuchi (Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine).

Research members: Shin-ichi Kikuchi, Shin-ichi Konno, Miho Sekiguchi (Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine), Kazuhisa Takahashi, Seiji Ohtori (Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University), Tatsuyuki Kakuma, Koji Yonemoto (Bio-statistics Center, Kurume University), Kazuo Yonenobu (Department of Orthopaedic Surgery, Osaka Minami Medical Center), Keisuke Takahashi, Hideki Iizuka (Department of Orthopaedic Surgery, Saitama Medical University, Faculty of Medicine), Toshihiko Taguchi, Tukasa Kanchiku (Department of Orthopaedic Surgery, Yamaguchi University Faculty of Medicine and Health Sciences), Katsushi Takeshita, Nobuhiro Hara (Department of Orthopaedic Surgery, The University of Tokyo Faculty of Medicine), Toshikazu Tani, Ryuichi Takemasa (Department of Orthopaedic Surgery, Kochi Medical School), Kazuhiro Chiba (Department of Orthopaedic Surgery, Kitasato University Kitasato Institute Hospital), Naofumi Hozogane (Department of Orthopaedic Surgery, Keio University School of Medicine), Kensei Nagata, Kimiaki Sato (Department of Orthopaedic Surgery, Kurume University School of Medicine), Yutaka Nohara, Hiroshi Teneichi (Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine), Yuichi Hoshino, Atsushi Seichi (Department of Orthopaedic Surgery, Jichi Medicine University), Toshihiko Yamashita, Tsuneo Takebayashi (Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine), Munehito Yoshida, Hiroshi Yamada (Department of Orthopaedic Surgery, Wakayama Medical University).

Research Associate members: Takuya Nikaido, Kazuyuki Watanabe, Kinshi Kato (Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine).

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Kato, K., Sekiguchi, M., Yonemoto, K. et al. Diagnostic accuracy of the Self-administered, Self-reported History Questionnaire for lumbar spinal stenosis patients in Japanese primary care settings: a multicenter cross-sectional study (DISTO-project). J Orthop Sci 20, 805–810 (2015). https://doi.org/10.1007/s00776-015-0740-6

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  • DOI: https://doi.org/10.1007/s00776-015-0740-6

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