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Assessment of Construct Validity of the Oswestry Disability Index and the Scoliosis Research Society–30 Questionnaire (SRS-30) in Patients With Degenerative Spinal Disease

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Abstract

Study Design

Observational cohort study.

Objectives

To measure and compare the structural validity of the Oswestry Disability Index (ODI) and the Scoliosis Research Society–30 (SRS-30) questionnaire in an adult population with prolonged degenerative thoracolumbar disease.

Summary of Background Data

The ODI and the SRS-30 are commonly used patient-reported outcome instruments to assess back-specific disability and symptoms related to scoliosis. Still, these instruments have not been validated for degenerative spinal disease with different stages of deformity.

Methods

Altogether, 637 consecutive adult patients with degenerative spinal pathologies were included. The patients completed the ODI (version 2.0), the 23 preoperative items of the SRS-30, a general health survey, the Kasari Frequency Intensity Time (FIT) index, the Depression Scale (DEPS), the RAND-36, and visual analog scales for leg and back pain instruments. Psychometric statistical and illustrative analyses were conducted. Deformity groups were analyzed to assess how well the two instruments reflect deformity-related back problems.

Results

Both instruments reflected good coverage and targeting. Correlation between the ODI and the SRS-30 was high (r = 0.70; p < .001). Both measures could distinguish between different general health states. The SRS-30 strongly reflected mental state and social well-being. The SRS-30 was less sensitive for pain and function. Furthermore, the principal component of pain/function explained more variance in the SRS-30 compared with the ODI score. The ODI was more sensitive for variance of disability among different age and deformity groups.

Conclusions

Both the ODI and the the SRS-30 provide valid scores in evaluating health-related quality of life and/or level of disability among patients with prolonged degenerative thoracolumbar disease. The ODI has slightly higher correlation with physical functioning. The SRS-30 seems to be better when evaluating the emotional and psychological functions.

Level of Evidence

Level III.

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References

  1. Andersson GBJ. Epidemiological features of chronic low-back pain. Lancet 1999;354:581–5.

    Article  CAS  Google Scholar 

  2. Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet 2018;391:2356–67.

    Article  Google Scholar 

  3. Andersson GB. Epidemiology of low back pain. Acta Orthopaedica Scandinavica 1998;69(suppl 281):28–31.

    Article  Google Scholar 

  4. Frank A. Low back pain. BMJ 1993;306:901–9.

    Article  CAS  Google Scholar 

  5. McGuirk B, King W, Govind J, et al. Safety, efficacy, and cost effectiveness of evidence-based guidelines for the management of acute low back pain in primary care. Spine 2001;26:2615–22.

    Article  CAS  Google Scholar 

  6. van Tulder MW, Ostelo R, Vlaeyen JW, et al. Behavioral treatment for chronic low back pain: a systematic review within the framework of the cochrane back review group. Spine 2000;25:2688–99.

    Article  Google Scholar 

  7. Kamper SJ, Apeldoorn A, Chiarotto A, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ 2015;350:h444.

    Article  Google Scholar 

  8. Aebi M. The adult scoliosis. Eur Spine J 2005;14:925–48.

    Article  Google Scholar 

  9. Kyrola K, Repo J, Mecklin JP, et al. Spinopelvic changes based on the simplified SRS-Schwab adult spinal deformity classification: relationships with disability and health-related quality of life in adult patients with prolonged degenerative spinal disorders. Spine (Phila Pa 1976) 2018;43:497–502.

    Article  Google Scholar 

  10. Schwab F, Dubey A, Gamez L, et al. Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine 2005;30:1082–5.

    Article  Google Scholar 

  11. Guyatt GH, Kirshner B, Jaeschke R. Measuring health status: what are the necessary measurement properties? J Clin Epidemiol 1992;45:1341–5.

    Article  CAS  Google Scholar 

  12. Guyatt G, Walter S, Norman G Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis 1987;40:171–8.

    Article  CAS  Google Scholar 

  13. Black N. Patient reported outcome measures could help transform healthcare. BMJ 2013;346:f167.

    Article  Google Scholar 

  14. Wild D, Grove A, Martin M, et al. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health 2005;8:94–104.

    Article  Google Scholar 

  15. Mokkink LB, Terwee CB, Patrick DL, et al. 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 2010;19:539–49.

    Article  Google Scholar 

  16. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 2000;25:3186–91.

    Article  CAS  Google Scholar 

  17. Fairbank JC, Pynsent PB. The oswestry disability index. Spine (Phila Pa 1976) 2000;25:2940–52; discussion 2952.

    Article  CAS  Google Scholar 

  18. Baldus C, Bridwell K, Harrast J, et al. The scoliosis research society health-related quality of life (SRS-30) age—gender normative data: an analysis of 1346 adult subjects unaffected by scoliosis. Spine 2011;36:1154–62.

    Article  Google Scholar 

  19. Kyrola K, Jarvenpaa S, Ylinen J, et al. Reliability and validity study of the finnish adaptation of scoliosis research society questionnaire version SRS-30. Spine (Phila Pa 1976) 2017;42:943–9.

    Article  Google Scholar 

  20. Pekkanen L, Kautiainen H, Ylinen J, et al. Reliability and validity study of the Finnish version 2.0 of the Oswestry Disability Index. Spine 2011;36:332–8.

    Article  Google Scholar 

  21. Ghandehari H, Mahabadi MA, Mahdavi SM, et al. Evaluation of patient outcome and satisfaction after surgical treatment of adolescent idiopathic scoliosis using Scoliosis Research Society-30. Arch Bone Joint Surg 2015;3:109–13.

    PubMed  Google Scholar 

  22. Scoliosis Research Society. Adolescent idiopathic scoliosis, 2003. https://www.srs.org/UserFiles/file/outcomes/srs-30.pdf. Accessed July 13, 2018.

  23. Kyrölä K, Häkkinen AH, Ylinen J, Repo JP. Further validation of the Scoliosis Research Society (SRS-30) questionnaire among adult patients with degenerative spinal disorder. Disabil Rehabil 2019:1–6.

  24. Salokangas RK, Poutanen O, Stengard E. Screening for depression in primary care. Development and validation of the depression scale, a screening instrument for depression. Acta Psychiatr Scand 1995;92:10–6.

    Article  CAS  Google Scholar 

  25. Hays Ron D, Sherbourne CD, Mazel RM. The RAND 36-item health survey 1.0. Health Econ 1993;2:217–27.

    Article  Google Scholar 

  26. Zanoli G, Stromqvist B, Jonsson B. Visual analog scales for interpretation of back and leg pain intensity in patients operated for degenerative lumbar spine disorders. Spine (Phila Pa 1976) 2001;26:2375–80.

    Article  CAS  Google Scholar 

  27. 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 

  28. Poutanen O, Koivisto AM, Salokangas RK. The depression scale (DEPS) as a case finder for depression in various subgroups of primary care patients. Eur Psychiatry 2008;23:580–6.

    Article  Google Scholar 

  29. Poutanen O, Koivisto AM, Salokangas RK. Applicability of the DEPS depression scale: assessing format and individual items in subgroups of patients. Nordic J Psychiatry 2010;64:384–90.

    Article  Google Scholar 

  30. Poutanen O, Koivisto A-M, Kääriä S, Salokangas RKR. The validity of the depression scale (DEPS) to assess the severity of depression in primary care patients. Family Pract 2010;27:527–34.

    Article  Google Scholar 

  31. Kasari D. The effects of exercise and fitness on serum lipids in college women. Unpublished master’s thesis, University of Montana; 1976. p. 46.

  32. Venables WN, Ripley BD. Modern Applied Statistics With S-PLUS. New York: Springer; 1997.

    Book  Google Scholar 

  33. Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. Lancet 2012;379:482–91.

    Article  Google Scholar 

  34. Chapman JR, Norvell DC, Hermsmeyer JT, et al. Evaluating common outcomes for measuring treatment success for chronic low back pain. Spine 2011;36:S54–68.

    Article  Google Scholar 

  35. Pizones J, Martin-Buitrago MP, Perez-Grueso FJS, et al. Function and clinical symptoms are the main factors that motivate thoracolumbar adult scoliosis patients to pursue surgery. Spine 2017;42:E31–6.

    Article  Google Scholar 

  36. Scheer JK, Smith JS, Clark AJ, et al. Comprehensive study of back and leg pain improvements after adult spinal deformity surgery: analysis of 421 patients with 2-year follow-up and of the impact of the surgery on treatment satisfaction. J Neurosurg Spine 2015;22:540–53.

    Article  Google Scholar 

  37. Koleck M, Mazaux JM, Rascle N, Bruchon-Schweitzer M. Psychosocial factors and coping strategies as predictors of chronic evolution and quality of life in patients with low back pain: a prospective study. Eur J Pain 2006;10:1–11.

    Article  Google Scholar 

  38. Penedo FJ, Dahn JR. Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Curr Opin Psychiatry 2005;18:189–93.

    Article  Google Scholar 

  39. Saltychev M, Mattie R, McCormick Z, Bärlund E, Laimi K. Psychometric properties of the oswestry disability index. Int J Rehabil Res 2017;40(3):202–8.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, Central Finland Central Hospital, Keskussairaalantie 19, Jyväskylä, 40620, Finland

    Jussi P. Repo PhD, MD, Ville T. Ponkilainen MD & Kati Kyrölä PhD, MD

  2. Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Keskussairaalantie 19, Jyväskylä, 40620, Finland

    Arja H. Häkkinen PhD & Jari Ylinen PhD, MD

  3. Faculty of Sport and Health Sciences, University of Jyväskylä, Seminaarinkatu 15, Jyväskylä yliopisto, 40014, Finland

    Arja H. Häkkinen PhD

  4. Department of Public Health, Biostatistics consulting, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    Paula Bergman MSc

Authors
  1. Jussi P. Repo PhD, MD
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  2. Ville T. Ponkilainen MD
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  3. Arja H. Häkkinen PhD
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  4. Jari Ylinen PhD, MD
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  5. Paula Bergman MSc
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  6. Kati Kyrölä PhD, MD
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Corresponding author

Correspondence to Ville T. Ponkilainen MD.

Additional information

Author disclosures: JPR (none), VTP (none), AHH (none), JY (none), PB (none), KK (none).

Funding: Dr Kati Kyrölä is currently receiving grants from Government Health Research Funding (B1411) and the Central Hospital of the Central Finland Scientific Committee Temporary Fund. The remaining authors declare no conflicts of interest.

IRB approval: This study was approved by the Research Ethics Committee of the Central Finland Health Care District.

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Repo, J.P., Ponkilainen, V.T., Häkkinen, A.H. et al. Assessment of Construct Validity of the Oswestry Disability Index and the Scoliosis Research Society–30 Questionnaire (SRS-30) in Patients With Degenerative Spinal Disease. Spine Deform 7, 929–936 (2019). https://doi.org/10.1016/j.jspd.2019.04.008

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  • DOI: https://doi.org/10.1016/j.jspd.2019.04.008

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