Abstract
Study Design
Longitudinal cohort.
Objectives
To determine the responsiveness of the Spinal Appearance Questionnaire (SAQ) in patients with adolescent idiopathic scoliosis (AIS) undergoing surgical correction of the deformity.
Summary of Background Data
The SAQ has been found to be a valid and reliable measure in patients with AIS. A recently published factor analysis and scoring system has been shown to be applicable to all Lenke types and had greater correlation to the curve magnitude than the Scoliosis Research Society (SRS) Appearance and Total score.
Methods
From a prospective multicenter database, 126 AIS patients who underwent correction of the spinal deformity with complete SAQ and SRS-22 Revised data at baseline and 2-year follow-up were identified. Discriminative properties of the SAQ domains (Expectations, Appearance, and Total) and SRS domains (Appearance, Activity, Pain, Mental, Satisfaction, and Total) were compared by computing the effect size (ES) and the standardized response mean (SRM).
Results
The SAQ Total had the largest ES (1.8) and SRM (1.5). This was followed by the SAQ Appearance, with an ES of 1.7 and SRM of 1.4; and the SAQ Expectations, with an ES of 1.5 and SRM of 1.2. Among the different SRS domains, only the Appearance (ES = 1.2, SRM = 1.1), Satisfaction (ES = 0.8, SRM = 0.6), and Total scores (ES = 0.8, SRM = 0.9) had effect sizes that were considered large. The SRS Mental domain had a moderate effect size (ES = 0.3, SRM = 0.3), whereas the Activity (ES = 0.0, SRM = 0.0) and Pain (ES = 0.2, SRM = 0.2) domains had small effect sizes.
Conclusions
The SAQ is sensitive and responsive to change, as evidenced by the large effect size for both domain and the Total score. The effect sizes are larger than those for any of the SRS domains, including Appearance and Total scores.
Similar content being viewed by others
References
Asher MA, Lai SM, Glattes RC, et al. Refinement of the SRS-22 Health-Related Quality of Life questionnaire Function domain. Spine (Phila Pa 1976) 2006;31:593–7.
Asher M, Min Lai S, Burton D, Manna B. Discrimination validity of the scoliosis research society-22 patient questionnaire: relationship to idiopathic scoliosis curve pattern and curve size. Spine 2003;28:74–8.
Asher M, Min Lai S, Burton D, Manna B. Scoliosis Research Society-22 patient questionnaire: responsiveness to change associated with surgical treatment. Spine 2003;28:70–3.
Asher M, Min Lai S, Burton D, Manna B. The reliability and concurrent validity of the Scoliosis Research Society-22 patient questionnaire for idiopathic scoliosis. Spine 2003;28:63–9.
Glattes RC, Burton DC, Lai SM, et al. The reliability and concurrent validity of the Scoliosis Research Society-22r patient questionnaire compared with the Child Health Questionnaire-CF87 patient questionnaire for adolescent spinal deformity. Spine (Phila Pa 1976) 2007;32:1778–84.
Feise RJ, Donaldson S, Crowther ER, et al. Construction and validation of the scoliosis quality of life index in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2005;30:1310–5.
Parent EC, Dang R, Hill D, Mahood J, et al. Score distribution of the Scoliosis Research Society-22 questionnaire in subgroups of patients of all ages with idiopathic scoliosis. Spine (Phila Pa 1976) 2010;35:568–77.
Parent EC, Wong D, Hill D, Mahood J, et al. The association between Scoliosis Research Society-22 scores and scoliosis severity changes at a clinically relevant threshold. Spine (Phila Pa 1976) 2010;35:315–22.
Parent EC, Hill D, Mahood J, et al. Discriminative and predictive validity of the Scoliosis Research Society-22 questionnaire in management and curve-severity subgroups of adolescents with idiopathic scoliosis. Spine (Phila Pa 1976) 2009;34:2450–7.
Carreon LY, Sander JO, Polly DW, et al. Spinal Appearance Questionnaire: factor analysis, scoring, reliability and validity testing. Spine (Phila Pa 1976) 2011;36:E1240–4.
Sanders JO, Harrast JJ, Kuklo TR, et al. The Spinal Appearance Questionnaire: results of reliability, validity, and responsiveness testing in patients with idiopathic scoliosis. Spine (Phila Pa 1976) 2007;32:2719–22.
Sanders JO, Polly Jr DW, Cats-Baril W, et al. Analysis of patient and parent assessment of deformity in idiopathic scoliosis using the Walter Reed Visual Assessment Scale. Spine (Phila Pa 1976) 2003;28:2158–63.
Cohen J. Statistical power analysis for the behavioral sciences. 2nd. Hillsdale, NJ: Lawrence Erlbaum; 1988.
Kazis LE, Anderson JJ, Meenan RF. Effect sizes for interpreting changes in health status. Med Care 1989;27:S178–89.
Guyatt G, Walter S, Norman G. Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis 1987;40:171–8.
Author information
Authors and Affiliations
Corresponding author
Additional information
Author disclosures: LYC (funds provided to database company by Medtronic and Nuvasive; board membership with Spine, The Spine Journal, University of Louisville IRB, Medtronic; employment with Norton Healthcare; grants from Norton Healthcare, Orthopedic Educational and Research Fund; travel/accommodations/meeting expenses from Orthopedic Educational and Research Fund, National Institutes of Health, University of Louisville IRB, Department of Defense, Association for Collaborative Spine Research; honoraria from Medtronic and National Institutes of Health); JOS (grants from POSNA, CWSDSG; payment for development of educational presentations from DePuy; stock/stock options from Abbot Labs, Hospira, Abbvie, GE, Biomedical Enterprises; travel/accommodations/meeting expenses from DePuy); MD (funds provided to database company by Medtronic and Nuvasive; consultancy for Fixes 4 Kids; grants from OREF; stock/stock options from Fixes for Kids); DWP (consultancy for Medtronic; funds provided to database company by Medtronic and Nuvasive; grants from Department of Defense, Orthopedic Research and Education Fund, Chest Wall and Spine Deformity Foundation, Minnesota Medical Foundation); BED (funds provided to database company by Medtronic and Nuvasive); DJS (funds provided to database company by Medtronic and Nuvasive; board membership with Scoliosis Research Society).
Rights and permissions
About this article
Cite this article
Carreon, L.Y., Sanders, J.O., Diab, M. et al. Discriminative Properties of the Spinal Appearance Questionnaire Compared With the Scoliosis Research Society—22 Revised. Spine Deform 1, 328–338 (2013). https://doi.org/10.1016/j.jspd.2013.06.001
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1016/j.jspd.2013.06.001