European Spine Journal

, Volume 24, Issue 1, pp 88–93 | Cite as

Reliability, responsiveness and interpretability of the neck disability index-Dutch version in primary care

  • Luc AillietEmail author
  • S. M. Rubinstein
  • H. C. W. de Vet
  • M. W. van Tulder
  • C. B. Terwee
Original Article



To establish an evidence-based recommendation for the pragmatic use of the Neck Disability Index-Dutch Version (NDI-DV) in primary care based on an assessment of the reliability, the responsiveness, and the interpretability of the NDI-DV.

Study design and setting/methods

At baseline, the NDI-DV was completed by 337 patients with neck pain presenting to 97 chiropractic clinics in Belgium and the Netherlands. Three months after inclusion, 265 patients provided data to assess the responsiveness and interpretability. Reliability was assessed in 155 patients (retested after 10 days) by calculating the intra-class correlation coefficient for agreement (ICCagreement) and the measurement error (standard error of measurement, SEM), the latter resulting in the smallest detectable change (SDC). The minimal important change (MIC) was assessed by the anchor-based MIC distribution using self-reported perceived recovery as anchor. We tested interpretability by relating SDC to MIC.


The ICCagreement was 0.88. The SEMagreement was 1.95 resulting in a SDC of 5.40. The NDI-DV appeared to be responsive, being able to distinguish improved from stable patients with an area under the curve of 0.85. The MIC was 4.50.


The NDI-DV has good reliability and responsiveness and may be used in clinical practice in Belgium and the Netherlands. A change score of 5 is important for patients, but has a 7 % chance to be due to measurement error.


Neck disability index Standard error of measurement Smallest detectable change Minimal important change Responsiveness Interpretability 


Conflict of interest

The authors declare that they have no competing interests. Luc Ailliet, the corresponding author, is as a Ph.D. student financially supported by the European Chiropractic Union, the Belgian Chiropractic Union, the Dutch Chiropractic Association (NCA) and l’Institut Franco-Européen de Chiropratique (IFEC, Paris, France). The views expressed in this manuscript are those of the authors, and no official endorsements by supporting agencies are intended or should be inferred.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Luc Ailliet
    • 1
    • 2
    Email author
  • S. M. Rubinstein
    • 1
    • 3
  • H. C. W. de Vet
    • 1
    • 2
  • M. W. van Tulder
    • 1
    • 3
  • C. B. Terwee
    • 1
    • 2
  1. 1.EMGO+ Institute for Health and Care ResearchVU University Medical CenterAmsterdamThe Netherlands
  2. 2.Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdamThe Netherlands
  3. 3.Faculty of Earth and Life Sciences, Institute of Health SciencesVU University AmsterdamAmsterdamThe Netherlands

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