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Patient Reported Outcomes in Adult Spinal Deformity Surgery: A Bibliometric Analysis

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Abstract

Study design

Bibliometric analysis.

Objectives

To identify patient-reported outcomes (PROs) used in adult spinal deformity (ASD) research over the past decade, their frequency, and usage trends.

Summary of background data

The emphasis on PROs is increasing along with the demand for evidence-based medicine. However, there is currently no standardization or consensus on which PROs ought to be used in ASD.

Methods

Five top orthopedics journals were reviewed from 2004 to 2013 for clinical studies of surgical intervention in ASD that report PROs. Publication year, level of evidence (LOE), and PROs were collected for each article. Errors and inconsistencies of PRO score re¬porting were analyzed for the 3 most commonly used PROs.

Results

A total of 84 PRO studies were published in ASD literature over the period studied. The number of PRO studies published increased from 1 in 2004 to 16 in 2013. We identified 24 unique PROs. The Oswestry Disability Index (ODI) was the most frequently used single instrument (47.8%), followed by the Scoliosis Research Society (SRS)-22 (35.6%) and SRS-24 (21.1%), and Short Form-36 (SF-36) and visual analog scale (VAS) were tied (13.3%). The combined use of SRS instruments exceeded ODI use. LOE 4 was most common (42.9%), and no LOE 1 studies were identified. Incomplete preoperative and postoperative PRO scores was the most common reporting inconsistency, occurring in 16% of articles using ODI, 58% of articles using SRS-24, and 22% of articles using SRS-22.

Conclusions

The frequency of studies using PROs in ASD research has increased over the past decade, yet quality studies and stan¬dardization are lacking. In general, the ODI and SRS instruments are emerging as standards in ASD surgery; however, frequent use of many uncommon PROs presents a challenge for interstudy comparisons. Additionally, of the top 5 instruments used, only SF-36 is routinely used for cost-effectiveness studies, making procedure cost—outcome decisions difficult. © 2015 Scoliosis Research Society.

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References

  1. McCarthy I, Hostin R, O’Brien M, et al. Health economic analysis of adult deformity surgery. Neurosurg Clin N Am 2013;24:293–304.

    Article  Google Scholar 

  2. Yadla S, Maltenfort MG, Ratliff JK, et al. Adult scoliosis surgery outcomes: a systematic review. Neurosurg Focus 2010;28:E3.

    Article  Google Scholar 

  3. OCEBM Levels of Evidence Working Group. Levels of Evidence (March 2009) [Oxford Center for Evidence-Based Medicine web site]. http://www.cebm.net/ocebm-levels-of-evidence/ Accessed June 6, 2014.

    Google Scholar 

  4. Bridwell KH, Berven S, Edwards 2nd C, et al. The problems and limitations of applying evidence-based medicine to primary surgical treatment of adult spinal deformity. Spine (Phila Pa 1976) 2007;32(19 Suppl):S135–9.

    Article  Google Scholar 

  5. Berven S, Deviren V, Demir-Deviren S, et al. Studies in the modified Scoliosis Research Society Outcomes Instrument in adults: validation, reliability, and discriminatory capacity. Spine (Phila Pa 1976) 2003;28:2164–9; discussion 2169.

    Article  Google Scholar 

  6. Lai SM, Burton DC, Asher MA, et al. Converting SRS-24, SRS-23, and SRS-22 to SRS-22r: establishing conversion equations using regression modeling. Spine (Phila Pa 1976) 2011;36: E1525–33.

    Article  Google Scholar 

  7. Alanay A, Cil A, Berk H, et al. Reliability and validity of adapted Turkish Version of Scoliosis Research Society-22 (SRS-22) questionnaire. Spine (Phila Pa 1976) 2005;30:2464–8.

    Article  Google Scholar 

  8. Asher M, Min Lai S, Burton D, et al. The reliability and concurrent validity of the Scoliosis Research Society-22 patient questionnaire for idiopathic scoliosis. Spine (Phila Pa 1976) 2003;28:63–9.

    Article  Google Scholar 

  9. Burton DC, Glattes RC. Measuring outcomes in spinal deformity. Neurosurg Clin N Am 2007;18:403–5.

    Article  Google Scholar 

  10. Climent JM, Bago J, Ey A, et al. Validity of the Spanish version of the Scoliosis Research Society-22 (SRS-22) Patient Questionnaire. Spine (Phila Pa 1976) 2005;30:705–9.

    Article  Google Scholar 

  11. 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.

    Article  Google Scholar 

  12. Hashimoto H, Sase T, Arai Y, et al. Validation of a Japanese version of the Scoliosis Research Society-22 Patient Questionnaire among idiopathic scoliosis patients in Japan. Spine (Phila Pa 1976) 2007;32:E141–6.

    Article  Google Scholar 

  13. Mousavi SJ, Mobini B, Mehdian H, et al. Reliability and validity of the Persian version of the Scoliosis Research Society-22r questionnaire. Spine (Phila Pa 1976) 2010;35:784–9.

    Article  Google Scholar 

  14. Glassman SD, Schwab F, Bridwell KH, et al. Do 1-year outcomes predict 2-year outcomes for adult deformity surgery? Spine J 2009;9:317–22.

    Article  Google Scholar 

  15. Fairbank JC, Couper J, Davies JB, et al. The Oswestry low back pain disability questionnaire. Physiotherapy 1980;66:271–3.

    CAS  Google Scholar 

  16. Heary RF. Evaluation and treatment of adult spinal deformity. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves. J Neurosurg Spine 2004;2004:9–18.

    Article  Google Scholar 

  17. Ware Jr JE. Standards for validating health measures: definition and content. J Chronic Dis 1987;40:473–80.

    Article  Google Scholar 

  18. Walsh T. Point of view on the Oswestry Disability Index. Spine (Phila Pa 1976) 2000;25:2953.

    Google Scholar 

  19. Deyo RA, Patrick DL. Barriers to the use of health status measures in clinical investigation, patient care, and policy research. Med Care 1989;27(3 suppl):S254–68.

    Article  CAS  Google Scholar 

  20. Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976) 2000;25:2940–52; discussion 2952.

    Article  CAS  Google Scholar 

  21. Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine (Phila Pa 1976) 2000;25:3115–24.

    Article  CAS  Google Scholar 

  22. Fairbank JC. Use and abuse of Oswestry Disability Index. Spine (Phila Pa 1976) 2007;32:2787–9.

    Article  Google Scholar 

  23. Ware Jr JE, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473–83.

    Article  Google Scholar 

  24. Ware J. SF-36 Health Survey Update [SF-36 web site]. October 2, 2003. Available at: http://www.sf-36.org/tools/sf36.shtml. Accessed June 6, 2014.

  25. Guilfoyle MR, Seeley H, Laing RJ. The Short Form 36 health survey in spine disease—validation against condition-specific measures. Br J Neurosurg 2009;23:401–5.

    Article  Google Scholar 

  26. Carreon LY, Bratcher KR, Das N, et al. Estimating EQ-5D Values From the Oswestry Disability Index and Numeric Rating Scales for Back and Leg Pain. Spine (Phila Pa 1976) 2014;39:678–82.

    Article  Google Scholar 

  27. Carreon LY, Glassman SD, McDonough CM, et al. Predicting SF-6D utility scores from the Oswestry disability index and numeric rating scales for back and leg pain. Spine (Phila Pa 1976) 2009;34:2085–9.

    Article  Google Scholar 

  28. Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 1990;13:227–36.

    Article  CAS  Google Scholar 

  29. Stiggelbout AM, Eijkemans MJ, Kiebert GM, et al. The “utility” of the visual analog scale in medical decision making and technology assessment. Is it an alternative to the time trade-off? Int J Technol Assess Health Care 1996;12:291–8.

    Article  CAS  Google Scholar 

  30. van den Akker ME, Arts MP, van den Hout WB, et al. Tubular diskectomy vs conventional microdiskectomy for the treatment of lumbar disk-related sciatica: cost utility analysis alongside a double-blind randomized controlled trial. Neurosurgery 2011;69:829–35; discussion 835–6.

    Article  Google Scholar 

  31. Hunt KJ, Hurwit D. Use of patient-reported outcome measures in foot and ankle research. J Bone Joint Surg Am 2013;95:e118 (1–9).

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY, 10029, USA

    Holt S. Cutler BSE, Javier Z. Guzman BS, Motasem Al Maaieh MD, James Connolly BA & Samuel K. Cho MD

  2. Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY, 10029, USA

    Branko Skovrlj MD

Authors
  1. Holt S. Cutler BSE
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  2. Javier Z. Guzman BS
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  3. Motasem Al Maaieh MD
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  4. James Connolly BA
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  5. Branko Skovrlj MD
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  6. Samuel K. Cho MD
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Corresponding author

Correspondence to Samuel K. Cho MD.

Additional information

Disclosure: HSC (None); JZG (None); MAM (None); JC (None) BS (None) SKC (None).

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Cutler, H.S., Guzman, J.Z., Al Maaieh, M. et al. Patient Reported Outcomes in Adult Spinal Deformity Surgery: A Bibliometric Analysis. Spine Deform 3, 312–317 (2015). https://doi.org/10.1016/j.jspd.2014.12.004

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  • DOI: https://doi.org/10.1016/j.jspd.2014.12.004

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