Abstract
Purpose
Among the many questionnaires available to evaluate low back pain (LBP) patients, the Core Outcome Measures Index (COMI) has the unique advantage to investigate five dimensions using seven short questions. The aim of this study was to explore additional properties of the questionnaire in a French-speaking non-surgical population.
Methods
This study was conducted on 168 patients suffering from subacute or chronic LBP and followed up for 6 months in three French-speaking countries. In addition to basic psychometric properties (e.g., construct validity, floor and ceiling effect, reproducibility), internal validity was analyzed by a factor analysis using Cronbach’s alpha. Responsiveness and sensitivity to change were assessed through minimal detectable change (MDC), effect size, and Minimal Clinically Important Improvement (MCII). We used an anchor-based method with receiver operating characteristic (ROC) curve analysis to assess MCII and the Patient Acceptable Symptom State.
Results
Construct validity, reliability (Cronbach’s alpha = 0.87), reproducibility and the absence of floor and ceiling effects were confirmed. Factor analysis indicated a one-dimensional construct that validates the use of a sum score. The MDC (2.1) was inferior to the MCII (2.3). The limit below which the patient claims to be in a fair condition (Patient Acceptable Symptom State) was set at 3.
Conclusions
The COMI is a self-report questionnaire with the capacity to easily and quickly explore several dimensions in patients with LBP that can be then summarized in a meaningful sum score. Additional knowledge provided by our study should encourage the widespread use of the COMI among the spine community.
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Acknowledgments
We thank all the team from “Nukleus” and, in particular, Mrs V. Gordin and M. Demonnet for their help and logistic support. We wish also to thank members of the Spine section of the French Rheumatology Society for their support in recruiting patients and Pfizer AG for their financial support. This study was supported by an unrestricted educational grant from Pfizer.
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Genevay, S., Marty, M., Courvoisier, D.S. et al. Validity of the French version of the Core Outcome Measures Index for low back pain patients: a prospective cohort study. Eur Spine J 23, 2097–2104 (2014). https://doi.org/10.1007/s00586-014-3325-8
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DOI: https://doi.org/10.1007/s00586-014-3325-8