Skip to main content

Advertisement

SpringerLink
Log in

Simplified Chinese version of the core outcome measures index (COMI) for patients with neck pain: cross-cultural adaptation and validation

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to translate and cross-culturally adapt the Core Outcome Measures Index for (COMI) into a Simplified Chinese version (COMI-SC) and to evaluate the reliability and validity of COMI-SC in patients with neck pain.

Methods

The COMI-neck was translated into Chinese according to established methods. The COMI-neck questionnaire was then completed by 122 patients with a hospital diagnosis of neck pain. Reliability was assessed by calculating Cronbach’s alpha and intraclass correlation coefficient (ICC). Construct validity was assessed by correlating the COMI-neck with the Neck Pain and Disability Scale (NPDS), the Neck Disability Index (NDI), the VAS and the Short Form (36) Health Survey (SF-36). Using confirmatory factor analysis to validate the structural, convergent and discriminant validity of the questionnaire.

Results

The COMI-neck total scores were well distributed, with no floor or ceiling effects. Internal consistency was excellent (Cronbach’s alpha = 0.861). Moderate to substantial correlations were found between COMI-neck and NPDS (r = 0.420/0.416/0.437, P < 0.001), NDI (r = 0.890, P < 0.001), VAS (r = 0.845, P < 0.001), as well as physical function (r = − 0.989, P < 0.001), physical role (r = − 0.597, P < 0.001), bodily pain (r = − 0. 639, P < 0.001), general health (r = − 0.563, P < 0.001), vitality (r = − 0.702, P < 0.001), social functioning (r = − 0.764, P < 0.001), role emotional (r = − 0.675, P < 0.001) and mental health (r = − 0.507, P < 0.001) subscales of the SF-36. An exploratory factor analysis revealed that the 3-factor loading explained 71.558% of the total variance [Kaiser-Mayer-Olkin (KMO) = 0.780, C2 = 502.82, P < 0.001]. CMIN/DF = 1.813, Tucker–Lewis index (TLI) = 0.966 (> 0.9), Comparative Fit Index (CFI) = 0.982 (> 0.9), Normed Fit Index (NFI) = 0.961 (> 0.9), RMSEA = 0.082 (< 0.5) indicating that the model fits well.

Conclusion

COMI-neck was shown to have acceptable reliability and validity in patients with non-specific chronic neck pain and could be recommended for patients in mainland China.

Level of evidence

Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Safiri S, Kolahi A-A, Hoy D et al (2020) Global, regional, and national burden of neck pain in the general population, 1990–2017: systematic analysis of the Global Burden of Disease Study 2017. BMJ. https://doi.org/10.1136/bmj.m791

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hoy D, March L, Woolf A, Blyth F, Brooks P, Smith E, Vos T, Barendregt J, Blore J, Murray C, Burstein R, Buchbinder R (2014) The global burden of neck pain: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 73:1309–1315. https://doi.org/10.1136/annrheumdis-2013-204431

    Article  PubMed  Google Scholar 

  3. Ferrari R, Russell AS (2003) Regional musculoskeletal conditions: neck pain. Best Pract Res Clin Rheumatol. 17:57–70. https://doi.org/10.1016/s1521-6942(02)00097-9

    Article  PubMed  Google Scholar 

  4. Côté P, Cassidy DJ, Carroll LJ, Kristman V (2004) The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain 112:267–273. https://doi.org/10.1016/j.pain.2004.09.004

    Article  PubMed  Google Scholar 

  5. Hoy DG, Protani M, De R, Buchbinder R (2010) The epidemiology of neck pain. Best Pract Res Clin Rheumatol 24:783–92. https://doi.org/10.1016/j.berh.2011.01.019

    Article  CAS  PubMed  Google Scholar 

  6. Bombardier C (2000) Outcome assessments in the evaluation of treatment of spinal disorders: summary and general recommendations. Spine (Phila Pa 1976). 25:3100–3103. https://doi.org/10.1097/00007632-200012150-00003

    Article  CAS  PubMed  Google Scholar 

  7. Jackowski D, Guyatt G (2003) A guide to health measurement. Clin Orthop Relat Res. https://doi.org/10.1097/01.blo.0000079771.06654.13

    Article  PubMed  Google Scholar 

  8. Guyatt GH, Feeny DH, Patrick DL (1993) Measuring health-related quality of life. Ann Intern Med 118:622–629. https://doi.org/10.7326/0003-4819-118-8-199304150-00009

    Article  CAS  PubMed  Google Scholar 

  9. Freedman KB, Back S, Bernstein J (2001) Sample size and statistical power of randomised, controlled trials in orthopaedics. J Bone Joint Surg Br 83:397–402. https://doi.org/10.1302/0301-620x.83b3.10582

    Article  CAS  PubMed  Google Scholar 

  10. 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 Epidemio. 60:34–42. https://doi.org/10.1016/j.jclinepi.2006.03.012

    Article  Google Scholar 

  11. Guillemin F, Bombardier C, Beaton D (1993) Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 46:1417–1432. https://doi.org/10.1016/0895-4356(93)90142-n3

    Article  CAS  PubMed  Google Scholar 

  12. Pynsent PB (2001) Choosing an outcome measure. J Bone Joint Surg Br 83:792–794. https://doi.org/10.1302/0301-620x.83b6

    Article  CAS  PubMed  Google Scholar 

  13. 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 (Phila Pa 1976) 23:2003–2013. https://doi.org/10.1097/00007632-199809150-00018

    Article  CAS  PubMed  Google Scholar 

  14. Melloh M, Staub L, Aghayev E, Zweig T, Barz T, Theis JC, Chavanne A, Grob D, Aebi M, Roeder C (2008) The international spine registry SPINE TANGO: status quo and first results. Eur Spine J. 17:1201–129. https://doi.org/10.1007/s00586-008-0665-2

    Article  PubMed  PubMed Central  Google Scholar 

  15. White P, Lewith G, Prescott P (2004) The core outcomes for neck pain: validation of a new outcome measure. Spine (Phila Pa 1976) 29:1923–1930. https://doi.org/10.1097/01.brs.0000137066.50291.da

    Article  PubMed  Google Scholar 

  16. Fankhauser CD, Mutter U, Aghayev E, Mannion AF (2012) Validity and responsiveness of the Core Outcome Measures Index (COMI) for the neck. Eur Spine J 21:101–114. https://doi.org/10.1007/s00586-011-1921-4

    Article  CAS  PubMed  Google Scholar 

  17. Karabicak GO, Hazar Kanik Z, Gunaydin G, Pala OO, Citaker S (2020) Reliability and validity of the Turkish version of the core outcome measures index for the neck pain. Eur Spine J. 29:186–193. https://doi.org/10.1007/s00586-019-06169-w

    Article  PubMed  Google Scholar 

  18. Miekisiak G, Banach M, Kiwic G et al (2014) Reliability and validity of the Polish version of the core outcome measures index for the neck. Eur Spine J 23:898–903. https://doi.org/10.1007/s00586-013-3129-2

    Article  PubMed  Google Scholar 

  19. Gadjradj PS, Chin-See-Chong TC, Donk D et al (2021) Cross-cultural adaptation and psychometric validation of the Dutch version of the core outcome measures index for the neck in patients undergoing surgery for degenerative disease of the cervical spine. Neurospine 18:798–805. https://doi.org/10.14245/ns.2142682.341

    Article  PubMed  PubMed Central  Google Scholar 

  20. 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. https://doi.org/10.1097/00007632-200012150-00014

    Article  CAS  PubMed  Google Scholar 

  21. Vernon H, Mior S (1991) The neck disability index: a study of reliability and validity. J Manipulative Physiol Ther 14:409–415

    CAS  PubMed  Google Scholar 

  22. Wu S, Ma C, Mai M, Li G (2010) Translation and validation study of Chinese versions of the neck disability index and the neck pain and disability scale. Spine (Phila Pa 1976) 35:1575–1379. https://doi.org/10.1097/BRS.0b013e3181c6ea1b

    Article  PubMed  Google Scholar 

  23. Wheeler AH, Goolkasian P, Baird AC, Darden 2nd BV (1999) Development of the neck pain and disability scale item analysis, face, and criterion-related validity. Spine (Phila Pa 1976). 24:1290–1294. https://doi.org/10.1097/00007632-199907010-00004

    Article  CAS  PubMed  Google Scholar 

  24. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  25. Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 305:160–164. https://doi.org/10.1136/bmj.305.6846.160

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Huskisson EC (1974) Measurement of pain. Lancet 2:1127–1131. https://doi.org/10.1016/s0140-6736(74)90884-8

    Article  CAS  PubMed  Google Scholar 

  27. Li L, Wang HM, Shen Y (2003) Chinese SF-36 health survey: translation, cultural adaptation, validation, and normalisation. J Epidemiol Community Health 57:259–263. https://doi.org/10.1136/jech.57.4.259

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. McHorney CA, Tarlov AR (1995) Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res 4:293–307. https://doi.org/10.1007/BF015938823

    Article  CAS  PubMed  Google Scholar 

  29. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  CAS  PubMed  Google Scholar 

  30. Bland JM, Altman DG (1999) Measuring agreement in method comparison studies. Stat Methods Med Res. 8:135–160. https://doi.org/10.1177/096228029900800204

    Article  CAS  PubMed  Google Scholar 

  31. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310

    Article  CAS  PubMed  Google Scholar 

  32. Wei X, Wang Z, Yang C, Wu B, Liu X, Yi H, Chen Z, Wang F, Bai Y, Li J, Zhu X, Li M (2012) Development of a simplified Chinese version of the Hip Disability and Osteoarthritis Outcome Score (HOOS): cross-cultural adaptation and psychometric evaluation. Osteoarth Cart 20:1563–1567. https://doi.org/10.1016/j.joca.2012.08.018

    Article  CAS  Google Scholar 

  33. Korakakis V, Malliaropoulos N, Baliotis K, Papadopoulou S, Padhiar N, Nauck T, Lohrer H (2015) Cross-cultural adaptation and validation of the exercise-induced leg pain questionnaire for English- and Greek-speaking individuals. J Orthop Sports Phys Ther 45:485–496. https://doi.org/10.2519/jospt.2015.5428

    Article  PubMed  Google Scholar 

  34. Hyland ME (2003) A brief guide to the selection of quality of life instrument. Health Qual Life Outcomes. https://doi.org/10.1186/1477-7525-1-24

    Article  PubMed  PubMed Central  Google Scholar 

  35. Monticone M, Ferrante S, Maggioni S et al (2014) Reliability, validity and responsiveness of the cross-culturally adapted Italian version of the core outcome measures index (COMI) for the neck. Eur Spine J Off Publ Eur Spine Soci, Eur Spinal Deform Soci. https://doi.org/10.1007/s00586-013-3092-y

    Article  Google Scholar 

Download references

Acknowledgements

This study was funded by the National Natural Science Foundation of China (Grant No.81972128).

Author information

Authors and Affiliations

  1. Department of Orthopaedics, The 4th Medical Center, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, People’s Republic of China

    Yuan Dong, Shiqi Cao, Dingfei Qian, Haichao Yu, Zelong Song, Wenhao Hu & Xuesong Zhang

  2. Chinese PLA Medical School, Beijing, People’s Republic of China

    Yuan Dong & Dingfei Qian

  3. Department of Orthopaedics of TCM Clinical Unit, 6th Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China

    Shiqi Cao

  4. Department of Orthopedics, Beijing Jishuitan Hospital, Beijing, 100035, People’s Republic of China

    Chengqi Jia

  5. School of Medicine, Nankai University, Tianjin, People’s Republic of China

    Haichao Yu & Zelong Song

Authors
  1. Yuan Dong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shiqi Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dingfei Qian
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Haichao Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Zelong Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chengqi Jia
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Wenhao Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Xuesong Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xuesong Zhang.

Ethics declarations

Conflict of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dong, Y., Cao, S., Qian, D. et al. Simplified Chinese version of the core outcome measures index (COMI) for patients with neck pain: cross-cultural adaptation and validation. Eur Spine J 33, 386–393 (2024). https://doi.org/10.1007/s00586-023-08088-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-023-08088-3

Keywords

Search

Navigation