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Impact of radiologic variables on item responses of ODI, SRS22 and SF-36. in adult spinal deformity patients: differential item functioning (DIF) analysis results from a multi-center database

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Abstract

Purpose

To determine if responses given to each question of the Scoliosis Research Society-22 (SRS22), Oswestry disability index (ODI) and Short Form-36 (SF-36) questionnaires are influenced by the radiological parameters.

Methods

Patients enrolled in a multi-centre prospectively collected adult spinal deformity database who had complete SRS22, ODI and SF-36 data at baseline and at one-year follow-up were analysed. The presence of a differential item function of each question within each score in relation to radiological parameters was analysed using a mixed Rasch model with the radiological threshold value(s) determined.

Results

Of those patients analysed (n = 1745; 1406 female, average age 51.0 ± 19.8 years), 944 were surgically and 801 were non-surgically treated. For the SRS22, questions (Q) 3, 5 and 18 were sensitive to almost all radiological parameters and the overall score was found sensitive to the Cobb angle. For the ODI, Q3, 6, 9 and 10 were not sensitive to any radiologic parameters whereas Q4 and 5 were sensitive to most. In contrast, only 3 of the SF-36 items were sensitive to radiological parameters.

Conclusions

78% of the SRS-22, 60% of the ODI and 8% of the questions in the SF-36 are sensitive to radiological parameters. Sagittal imbalance is independently associated with a poor overall outcome, but affects mental status and function more than pain and self-image. The assembly of questions responsive to radiological parameters may be useful in establishing a connection between changes in radiologic parameters and HRQL.

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Acknowledgements

Glenny Kieser for her editorial input.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch School of Medicine, 2 Riccarton Avenue, 8011, Christchurch, New Zealand

    D. C. Kieser

  2. School of Medicine Ankara, Ankara Yildirim Beyazit University, Ankara, Turkey

    S. Yuksel

  3. L’Institut de la Colonne Vertébrale, CHU Pellegrin, 33076, Bordeaux, France

    L. Boissiere, D. T. Cawley, K. Hayashi, Vital Jean-Marc, A. Bourghli & I. Obeid

  4. Department of Orthopedics and Traumatology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey

    A. Alanay

  5. Mater Private Hospital, Dublin, Ireland

    C. Yilgor & D. T. Cawley

  6. Spine Center, Schulthess Klinik, Zurich, Switzerland

    F. S. Kleinstueck

  7. Spine Surgery Unit, Hospital Universitario Val Hebron, Barcelona, Spain

    F. Pellise

  8. Spine Surgery Unit, Hospital Universitario La Paz, Madrid, Spain

    F. J. S. Perez-Grueso

  9. Ankara Spine Center, Ankara, Turkey

    E. R. Acaroglu

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  1. D. C. Kieser
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  2. S. Yuksel
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  11. Vital Jean-Marc
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  14. I. Obeid
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Correspondence to D. C. Kieser.

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Kieser, D.C., Yuksel, S., Boissiere, L. et al. Impact of radiologic variables on item responses of ODI, SRS22 and SF-36. in adult spinal deformity patients: differential item functioning (DIF) analysis results from a multi-center database. Eur Spine J 31, 1166–1173 (2022). https://doi.org/10.1007/s00586-021-07088-5

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  • DOI: https://doi.org/10.1007/s00586-021-07088-5

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