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Cross-cultural adaptation and validation of the Norwegian version of the Core Outcome Measures Index for low back pain

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Abstract

Purpose

The Core Outcome Measures Index (COMI) is a short multidimensional scale covering all domains recommended to be included as outcome measures for patients with low back pain (LBP). The purpose of the present study was to translate and cross-culturally adapt the COMI into Norwegian and to test clinimetric properties of the Norwegian COMI version in patients with non-specific LBP recruited from various clinical settings.

Methods

Ninety patients with non-specific LBP from primary care and hospital settings participated in the validation part and 61 also in the reproducibility part of the study (1 week apart). Acceptability, data quality, reproducibility and construct validity were investigated.

Results

The questionnaire was well accepted and with little missing data and end effects. Reliability in terms of intraclass correlations (ICC) was satisfactory for the COMI index [0.89 (95 % CI 0.82–0.94)] and most single-core items. Agreement was acceptable for the COMI index [standard error of measurement (SEMagreement) 0.80, minimal detectable change (MDCindividual) 2.21], but exceeded the minimal standard of acceptability in some of the individual core items. Construct validity was acceptable for the COMI index.

Conclusion

The Norwegian version of the COMI index shows acceptable clinimetric properties in our patient population, but some of the sub-items had shortcomings. Our study, however, support the usefulness of the COMI index as an applicable stand-alone global scale when a light respondent burden is advisable.

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References

  1. The EuroQol Group (1990) EuroQol–a new facility for the measurement of health-related quality of life. Health Policy 16:199–208

    Google Scholar 

  2. Altman DG (1991) Practical statistics for medical research. Chapman and Hall, London

    Google Scholar 

  3. Andresen EM (2000) Criteria for assessing the tools of disability outcomes research. Arch Phys Med Rehabil 81(12 Suppl 2):S15–S20

    Article  PubMed  CAS  Google Scholar 

  4. Beaton DE, Bombardier C, Guillemin F, Ferraz MB (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 25:3186–3191

    Article  PubMed  CAS  Google Scholar 

  5. Bombardier C (2000) Outcome assessments in the evaluation of treatment of spinal disorders: summary and general recommendations. Spine 25:3100–3103

    Article  PubMed  CAS  Google Scholar 

  6. Broadbent E, Petrie KJ, Main J, Weinman J (2006) The brief illness perception questionnaire. J Psychosom Res 60:631–637

    Article  PubMed  Google Scholar 

  7. Damasceno LH, Rocha PA, Barbosa ES, Barros CA, Canto FT, Defino HL, Mannion AF (2011) Cross-cultural adaptation and assessment of the reliability and validity of the Core Outcome Measures Index (COMI) for the Brazilian–Portuguese language. Eur Spine J (Epub ahead of print)

  8. Davidson M, Keating JL (2002) A comparison of five low back disability questionnaires: reliability and responsiveness. Phys Ther 82:8–24

    PubMed  Google Scholar 

  9. Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L (1974) The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behav Sci 19:1–15

    Article  PubMed  CAS  Google Scholar 

  10. Deyo RA, Battie M, Beurskens AJ, Bombardier C, Croft P, Koes B, Malmivaara A, Roland M, Von Korff M, Waddell G (1998) Outcome measures for low back pain research. A proposal for standardized use. Spine 23:2003–2013

    Article  PubMed  CAS  Google Scholar 

  11. Ferrer M, Pellise F, Escudero O, Alvarez L, Pont A, Alonso J, Deyo R (2006) Validation of a minimum outcome core set in the evaluation of patients with back pain. Spine Phila Pa 31:1372–1379

    Article  Google Scholar 

  12. Genevay S, Cedraschi C, Marty M, Rozenberg S, De GP, Faundez A, Balague F, Porchet F, Mannion AF (2011) Reliability and validity of the cross-culturally adapted French version of the Core Outcome Measures Index (COMI) in patients with low back pain. Eur Spine J 21(1):130–137

    Article  PubMed  Google Scholar 

  13. Grotle M, Brox JI, Vollestad NK (2005) Functional status and disability questionnaires: what do they assess? A systematic review of back-specific outcome questionnaires. Spine Phila Pa 30:130–140

    Google Scholar 

  14. Kessler JT, Melloh M, Zweig T, Aghayev E, Roder C (2010) Development of a documentation instrument for the conservative treatment of spinal disorders in the International Spine Registry, Spine Tango. Eur Spine J 20:369–379

    Article  PubMed  Google Scholar 

  15. Kleinstueck FS, Fekete T, Jeszenszky D, Mannion AF, Grob D, Lattig F, Mutter U, Porchet F (2011) The outcome of decompression surgery for lumbar herniated disc is influenced by the level of concomitant preoperative low back pain. Eur Spine J 20:1166–1173

    Article  PubMed  CAS  Google Scholar 

  16. Lattig F, Grob D, Kleinstueck FS, Porchet F, Jeszenszky D, Bartanusz V, O’Riordan D, Mannion AF (2009) Ratings of global outcome at the first post-operative assessment after spinal surgery: how often do the surgeon and patient agree? Eur Spine J 18(Suppl 3):386–394

    Article  PubMed  Google Scholar 

  17. Lurie J (2000) A review of generic health status measures in patients with low back pain. Spine 25:3125–3129

    Article  PubMed  CAS  Google Scholar 

  18. Mannion AF, Boneschi M, Teli M, Luca A, Zaina F, Negrini S, Schulz PJ (2011) Reliability and validity of the cross-culturally adapted Italian version of the Core Outcome Measures Index. Eur Spine J (Epub ahead of print)

  19. Mannion AF, Elfering A, Staerkle R, Junge A, Grob D, Semmer NK, Jacobshagen N, Dvorak J, Boos N (2005) Outcome assessment in low back pain: how low can you go? Eur Spine J 14:1014–1026

    Article  PubMed  Google Scholar 

  20. Mannion AF, Porchet F, Kleinstuck FS, Lattig F, Jeszenszky D, Bartanusz V, Dvorak J, Grob D (2009) The quality of spine surgery from the patient’s perspective: part 2. Minimal clinically important difference for improvement and deterioration as measured with the Core Outcome Measures Index. Eur Spine J 18(Suppl 3):374–379

    Article  PubMed  Google Scholar 

  21. Mannion AF, Porchet F, Kleinstuck FS, Lattig F, Jeszenszky D, Bartanusz V, Dvorak J, Grob D (2009) The quality of spine surgery from the patient’s perspective. Part 1: the Core Outcome Measures Index in clinical practice. Eur Spine J 18(Suppl 3):367–373

    Article  PubMed  Google Scholar 

  22. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC (2010) The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res 19:539–549

    Article  PubMed  Google Scholar 

  23. Nakash RA, Hutton JL, Jorstad-Stein EC, Gates S, Lamb SE (2006) Maximising response to postal questionnaires–a systematic review of randomised trials in health research. BMC Med Res Methodol 6:5

    Article  PubMed  Google Scholar 

  24. Roland M, Fairbank J (2000) The Roland-Morris disability questionnaire and the Oswestry disability questionnaire. Spine 25:3115–3124

    Article  PubMed  CAS  Google Scholar 

  25. Sobottke R, Rollinghoff M, Zarghooni K, Zarghooni K, Schluter-Brust K, Delank KS, Seifert H, Zweig T, Eysel P (2010) Spondylodiscitis in the elderly patient: clinical mid-term results and quality of life. Arch Orthop Trauma Surg 130:1083–1091

    Article  PubMed  Google Scholar 

  26. Staerkle RF, Villiger P (2011) Simple questionnaire for assessing core outcomes in inguinal hernia repair. Br J Surg 98:148–155

    Article  PubMed  CAS  Google Scholar 

  27. Streiner DL, Norman GR (1995) Health measurement scales: a practical guide to their development and use. Oxford University Press, Oxford

    Google Scholar 

  28. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60:34–42

    Article  PubMed  Google Scholar 

  29. Waddell G (1998) The back pain revolution. Churchill Livingstone, London

    Google Scholar 

  30. White P, Lewith G, Prescott P (2004) The core outcomes for neck pain: validation of a new outcome measure. Spine 29(Phila Pa 17):1923–1930

    Article  PubMed  Google Scholar 

  31. Zweig T, Mannion AF, Grob D, Melloh M, Munting E, Tuschel A, Aebi M, Roder C (2009) How to Tango: a manual for implementing Spine Tango. Eur Spine J 18(Suppl 3):312–320

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors acknowledge clinicians at Hans and Olaf physiotherapy institute, Hjelp24NIMI, Stadion Fysikalske, Aker University Hospital (pain clinic), Friskvernsenteret and the National Hospital (Orthopaedic Department) for recruiting patients for the study. We also thank all patients participating in the study.

Conflict of interest

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Correspondence to Kjersti Storheim.

Appendix

Appendix

The translation process: the translation and cross-cultural adaptation was conducted according to recommendations from international guidelines [4]. The original COMI version was first “forward” translated into Norwegian by two independent translators whose mother tongue is Norwegian and with different profiles (one clinician and one philologist). A consensus of the Norwegian translation was made before it was translated back into English by two native-English speaking translators, who were blinded to the original English version. In a formal meeting the translators, one health professional and the researchers in our research group reviewed all translations and discussed possible discrepancies until consensus on a final version of the COMI was achieved. The final translated Norwegian version was reviewed by the first patients included in the clinimetric study. Since they had no problems with reading, interpreting and filling in the questionnaire, no changes were made. The English and Norwegian versions follow below.

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Storheim, K., Brox, J.I., Løchting, I. et al. Cross-cultural adaptation and validation of the Norwegian version of the Core Outcome Measures Index for low back pain. Eur Spine J 21, 2539–2549 (2012). https://doi.org/10.1007/s00586-012-2393-x

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  • DOI: https://doi.org/10.1007/s00586-012-2393-x

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