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Li X, Li R, Li M, Yao L, Van Spall H, Zhao K, Chen Y, Xiao F, Fu Q, Xie F. A Systematic Review and Quality Assessment of Cardiovascular Disease-Specific Health-Related Quality-of-Life Instruments Part I: Instrument Development and Content Validity. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:1130-1148. [PMID: 38608875 DOI: 10.1016/j.jval.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 02/12/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVES Health-related quality-of-life (HRQoL) instruments for cardiovascular diseases (CVD) have been commonly used to measure important patient-reported outcomes (PROs) in clinical trials and practices. This study aimed at systematically identifying and assessing the content validity of CVD-specific HRQoL instruments in clinical studies. METHODS The research team searched Cumulative Index to Nursing and Allied Health Literature, Embase, and PubMed from inception to January 20, 2022. The research team included studies that reported the development and content validity for CVD-specific instruments. Two reviewers independently assessed the methodological quality using the Consensus-based Standards for the Selection of Health Measurement Instruments methods on evaluating content validity of PROs. Content analysis was used to categorize the items included in the instruments. RESULTS The research team found 69 studies reporting the content validity of 40 instruments specifically developed for CVD. Fourteen (35.0%) were rated "sufficient" with very low to moderate quality of evidence. For PRO development, all instruments were rated "doubtful" or "inadequate." Twenty-eight (70.0%) instruments cover the core concepts of HRQoL. CONCLUSIONS The quality of development and content validity vary among existing CVD-specific instruments. The evidence on the content validity should be considered when choosing a HRQoL instrument in CVD clinical studies and health economic evaluations.
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Affiliation(s)
- Xue Li
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China
| | - Rui Li
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China; Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Meixuan Li
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Liang Yao
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Harriette Van Spall
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; Research Institute of St Joseph's and Population Health Research Institute, Hamilton, ON, Canada
| | - Kun Zhao
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China; Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yunxiang Chen
- Department of Library, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China
| | - Feiyi Xiao
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China
| | - Qiang Fu
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; Center for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
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Lemmers GPG, Melis RJF, Hak R, de Snoo EK, Pagen S, Westert GP, Staal JB, van der Wees PJ. The association of physical activity and sedentary behaviour with low back pain disability trajectories: A prospective cohort study. Musculoskelet Sci Pract 2024; 72:102954. [PMID: 38691981 DOI: 10.1016/j.msksp.2024.102954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/22/2024] [Accepted: 04/09/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Multiple factors influence the recovery process of low back pain (LBP). The identification and increased knowledge of risk factors might contribute to a better understanding of the course of LBP. OBJECTIVES To investigate the association of habitual physical activity (PA) and sedentary behaviour (SB), measured at baseline, with disability trajectories in adults with LBP. METHODS A prospective cohort study where habitual PA levels were measured using the Short QUestionnaire to ASsess Health enhancing physical activity (SQUASH), SB was calculated as average sedentary hours per day, and LBP disability using the Oswestry Disability Index (ODI). Participants completed the questionnaires at one and a half, three, six, and twelve months. Linear mixed models were estimated to describe the association of habitual PA levels SB measured at baseline with disability trajectories. Other predictors were gender, education level, age, pain, number of previous episodes of LBP, and duration of LBP. RESULTS Habitual SB measured at baseline in adults (n = 347) with LBP were not associated with disability trajectories. For PA, participants with one metabolic equivalent of task (MET) hour per day above average recovered 0.04 [95% CI 0.004 to 0.076] points on the ODI per month faster than participants with an average amount of MET hours per day. CONCLUSIONS Habitual SB was not associated with LBP disability trajectories over a one-year follow-up. High levels of habitual PA at baseline were associated with improved recovery in LBP disability trajectory, but the finding is not clinically relevant.
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Affiliation(s)
- Gijs Petrus Gerardus Lemmers
- Radboud University Medical Center, IQ Health, Kapittelweg 54, 6525 EP, Nijmegen, the Netherlands; Dutch Healthcare Authority, Newtonlaan 1-41, 3584 BX, Utrecht, the Netherlands.
| | - René Johannes Fransiscus Melis
- Radboud University Medical Center, Department of Geriatric Medicine, Reinier Postlaan 4, 6525 EX, Nijmegen, the Netherlands.
| | - Robin Hak
- Fysius Back Experts, Bedrijvenweg 7, 7442 CX, Nijverdal, the Netherlands.
| | | | - Sophie Pagen
- TheFysioclub, Vicaris van der Asdonckstraat 55, 5421 VB, Gemert, the Netherlands.
| | - Gerard Pieter Westert
- Radboud University Medical Center, IQ Health, Kapittelweg 54, 6525 EP, Nijmegen, the Netherlands.
| | - Jacobus Bart Staal
- Radboud University Medical Center, IQ Health, Kapittelweg 54, 6525 EP, Nijmegen, the Netherlands; Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, Kapittelweg 33, 6525 EN, Nijmegen, the Netherlands.
| | - Philip Jan van der Wees
- Radboud University Medical Center, IQ Health, Kapittelweg 54, 6525 EP, Nijmegen, the Netherlands.
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Sannes AC, Ghani U, Niazi IK, Moberget T, Jonassen R, Haavik H, Gjerstad J. Investigating Whether a Combination of Electro-Encephalography and Gene Expression Profiling Can Predict the Risk of Chronic Pain: A Protocol for an Observational Prospective Cohort Study. Brain Sci 2024; 14:641. [PMID: 39061381 PMCID: PMC11274615 DOI: 10.3390/brainsci14070641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/20/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
Despite most episodes of low back pain (LBP) being short-lasting, some transition into persistent long-lasting problems. Hence, the need for a deeper understanding of the physiological mechanisms of this is pertinent. Therefore, the aims of the present study are (1) to map pain-induced changes in brain activity and blood gene expression associated with persistent LBP, and (2) to explore whether these brain and gene expression signatures show promise as predictive biomarkers for the development of persistent LBP. The participants will be allocated into three different pain groups (no pain, mild short-lasting, or moderate long-term). One in-person visit, where two blood samples will be collected and sent for RNA sequencing, along with resting 64-channel electro-encephalography measurements before, during, and after a cold pressor test, will be conducted. Thereafter, follow-up questionnaires will be distributed at 2 weeks, 3 months, and 6 months. Recruitment will start during the second quarter of 2024, with expected completion by the last quarter of 2024. The results are expected to provide insight into the relationship between central nervous system activity, gene expression profiles, and LBP. If successful, this study has the potential to provide physiological indicators that are sensitive to the transition from mild, short-term LBP to more problematic, long-term LBP.
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Affiliation(s)
- Ann-Christin Sannes
- Faculty of Health Science, Oslo Metropolitan University, 0890 Oslo, Norway
- Department for Research and Development in Mental Health, Akershus University Hospital, 1474 Lørenskog, Norway
| | - Usman Ghani
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand (I.K.N.)
- Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, AUT University, Auckland 1010, New Zealand
| | - Imran Khan Niazi
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand (I.K.N.)
- Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, AUT University, Auckland 1010, New Zealand
- Faculty of Medicine, Aalborg University, 9260 Aalborg, Denmark
| | - Torgeir Moberget
- Faculty of Health Sciences, Kristiania University College, 0107 Oslo, Norway
- Centre for Precision Psychiatry, University of Oslo, 0373 Oslo, Norway
| | - Rune Jonassen
- Faculty of Health Science, Oslo Metropolitan University, 0890 Oslo, Norway
| | - Heidi Haavik
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand (I.K.N.)
| | - Johannes Gjerstad
- Department for Research and Development in Mental Health, Akershus University Hospital, 1474 Lørenskog, Norway
- Faculty of Health Sciences, Kristiania University College, 0107 Oslo, Norway
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Alebouyeh F, Boutron I, Ravaud P, Tran VT. Psychometric properties and domains covered by patient-reported outcome measures used in trials assessing interventions for chronic pain. J Clin Epidemiol 2024; 170:111362. [PMID: 38615827 DOI: 10.1016/j.jclinepi.2024.111362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 04/03/2024] [Accepted: 04/07/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVES To identify the patient-reported outcome measures (PROMs) used in clinical trials assessing interventions for chronic pain, describe their psychometric properties, and the clinical domains they cover. STUDY DESIGN AND SETTING We identified phase 3 or 4 interventional trials: on adult participants (aged >18 years), registered in clinicaltrials.gov between January 1, 2021 and December 31, 2022, and which provided "chronic pain" as a keyword condition. We excluded diagnostic studies and phase 1 or 2 trials. In each trial, one reviewer extracted all outcomes registered and identified those captured using PROMs. For each PROM used in more than 1% of identified trials, two reviewers assessed whether it covered the six important clinical domains from the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT): pain, emotional functioning, physical functioning, participant ratings of global improvement and satisfaction with treatment, symptoms and adverse events, and participant disposition (eg, adherence to medication). Second, reviewers searched PubMed for both the initial publication and latest review reporting the psychometric properties of each PROM and assessed their content validity, structural validity, internal consistency, reliability, measurement error, hypotheses testing, criterion validity, and responsiveness using published criteria from the literature. RESULTS In total, 596 trials assessing 4843 outcomes were included in the study (median sample size 60, interquartile range 40-100). Trials evaluated behavioral (22%), device-based (21%), and drug-based (10%) interventions. Of 495 unique PROMs, 55 were used in more than 1% trials (16 were generic pain measures; 8 were pain measures for specific diseases; and 30 were measures of other symptoms or consequences of pain). About 50% PROMs had more than 50% of psychometric properties rated as sufficient. Scales often focused on a single clinical domain. Only 25% trials measured at least three clinical domains from IMMPACT. CONCLUSION Half of PROMs used in trials assessing interventions for chronic pain had sufficient psychometric properties for more than 50% of criteria assessed. Few PROMs assessed more than one important clinical domain. Only 25% of trials measured more than 3/6 clinical domains considered important by IMMPACT.
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Affiliation(s)
- Farzaneh Alebouyeh
- Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, AP-HP, Paris, France
| | - Isabelle Boutron
- Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, AP-HP, Paris, France; Université Paris Cité, CRESS, INSERM, INRAE, Paris, France
| | - Philippe Ravaud
- Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, AP-HP, Paris, France; Université Paris Cité, CRESS, INSERM, INRAE, Paris, France; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Viet-Thi Tran
- Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, AP-HP, Paris, France; Université Paris Cité, CRESS, INSERM, INRAE, Paris, France.
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do Nascimento Freitas DW, Dibai-Filho AV, Pontes-Silva A, Araujo GGC, de Oliveira AR, da Cunha Leal P, Gabel CP, Fidelis-de-Paula-Gomes CA, Cabido CET. Translation, cross-cultural adaptation, and validation of the 10-item spine functional index (SFI-10) in the Brazilians with musculoskeletal spine disorders. BMC Musculoskelet Disord 2024; 25:266. [PMID: 38575902 PMCID: PMC10996142 DOI: 10.1186/s12891-024-07406-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/02/2024] [Indexed: 04/06/2024] Open
Abstract
PURPOSE To translate and cross-culturally adapt the Spine Functional Index (SFI) into Brazilian Portuguese (SFI-Br) in individuals with musculoskeletal spine disorders. METHODS Participants (n=194) answered the Numerical Pain Rating Scale (NPRS), 36-item Short-Form Health Survey (SF-36), Roland-Morris Disability Questionnaire for General Pain (RMDQ-g), and SFI-25 incorporating the SFI-10. Structural validity, from confirmatory factor analysis (CFA), used comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and chi-square/degrees of freedom (DF). The best structure was considered from the lower values of the Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC). Construct and criterion validity used Spearman's correlation coefficient (rho). Internal consistency used Cronbach's alpha, reliability used intraclass correlation coefficient (ICC2,1), with ceiling and floor effects determined. Error used the standard error of the measurement (SEM) and minimal detectable change, 90% level (MDC90). RESULTS Adequate fit indices demonstrated an unequivocal one-factor structure only for the SFI-10 (chi-square/DF <3.00, CFI and TLI >0.90, RMSEA <0.08). The SFI-10-Br correlation was high with the SFI-Br (rho=0.914, p<0.001), moderate for the RMDQ-g (rho=-0.78), SF-36 functional capacity domain (rho=0.718) and NPRS (rho=-0.526); and adequate for the remaining SF-36 domains (rho>0.30). Test-retest reliability (ICC2,1=0.826) and internal consistency (alpha=0.864) were high. No ceiling or floor effects were observed, and error was satisfactory (SEM=9.08%, MDC90=25.15%). CONCLUSION The SFI Brazilian version was successfully produced with the 10-item version showing an unequivocal one-factor structure, high construct and criterion validity, reliability, internal consistency, and satisfactory error. Further research on responsiveness is required.
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Affiliation(s)
| | - Almir Vieira Dibai-Filho
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - André Pontes-Silva
- Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
| | | | | | - Plinio da Cunha Leal
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA, Brazil
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Thompson K, Lo AHY, McGlashan HL, Ownsworth T, Haslam C, Pegna A, Reutens DC. Measures of Subjective Memory for People with Epilepsy: A Systematic Review of Measurement Properties. Neuropsychol Rev 2024; 34:67-97. [PMID: 36633798 DOI: 10.1007/s11065-022-09568-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/21/2022] [Indexed: 01/13/2023]
Abstract
People with epilepsy frequently express concern about the burden of memory problems in their everyday lives. Self-report memory questionnaires may provide valuable insight into individuals' perceptions of their everyday memory performance and changes over time. Yet, despite their potential utility, the measurement properties of self-report memory questionnaires have not been evaluated in epilepsy. This systematic review aimed to provide a critical appraisal of the measurement properties of self-report memory questionnaires for adults with epilepsy. Following protocol registration (PROSPERO CRD42020210967), a systematic search of PubMed, EMBASE, Web of Science, CINAHL, and PsychInfo from database inception until 27 May 2021 was conducted. Eligible studies were published in English-language peer-reviewed journals, recruited adults with epilepsy, and reported on the development or evaluation of the measurement properties of a self-report memory questionnaire. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology was used to evaluate each study of a measurement property, and results were qualitatively synthesised. In total, 80 articles and one test manual were located containing 153 studies of measurement properties pertinent to 23 self-report memory questionnaires. Overall, no scale could be recommended outright for the evaluation of subjective memory symptoms in adults with epilepsy. This was due to the near absence of dedicated content validation studies relevant to this population and shortcomings in the methodology and scientific reporting of available studies of structural validity. Recommendations to support the advancement and psychometric validation of self-report memory questionnaires for people with epilepsy are provided.
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Affiliation(s)
- Kate Thompson
- Centre for Advanced Imaging, the University of Queensland, Brisbane, QLD, Australia.
- Psychology Department, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia.
- School of Psychology, the University of Queensland, Brisbane, QLD, Australia.
| | - Ada H Y Lo
- Psychology Department, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
- School of Psychology, the University of Queensland, Brisbane, QLD, Australia
| | - Hannah L McGlashan
- School of Psychology, the University of Queensland, Brisbane, QLD, Australia
- Surgical Treatment and Rehabilitation Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Tamara Ownsworth
- School of Applied Psychology and The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Catherine Haslam
- School of Psychology, the University of Queensland, Brisbane, QLD, Australia
| | - Alan Pegna
- School of Psychology, the University of Queensland, Brisbane, QLD, Australia
| | - David C Reutens
- Centre for Advanced Imaging, the University of Queensland, Brisbane, QLD, Australia
- Neurology Department, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
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7
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Battershell M, Vu H, Callander EJ, Slavin V, Carrandi A, Teede H, Bull C. Development, women-centricity and psychometric properties of maternity patient-reported outcome measures (PROMs): A systematic review. Women Birth 2023; 36:e563-e573. [PMID: 37316400 DOI: 10.1016/j.wombi.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/04/2023] [Accepted: 05/25/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Measuring maternity care outcomes based on what women value is critical to promoting woman-centred maternity care. Patient-reported outcome measures (PROMs) are instruments that enable service users to assess healthcare service and system performance. AIM To identify and critically appraise the risk of bias, woman-centricity (content validity) and psychometric properties of maternity PROMs published in the scientific literature. METHODS MEDLINE, CINAHL Plus, PsycINFO and Embase were systematically searched for relevant records between 01/01/2010 and 07/10/2021. Included articles underwent risk of bias, content validity and psychometric properties assessments in line with COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. PROM results were summarised according to language subgroups and an overall recommendation for use was determined. FINDINGS Forty-four studies reported on the development and psychometric evaluation of 9 maternity PROMs, grouped into 32 language subgroups. Risk of bias assessments for the PROM development and content validity showed inadequate or doubtful methodological quality. Internal consistency reliability, hypothesis testing (for construct validity), structural validity and test-retest reliability varied markedly in sufficiency and evidence quality. No PROMs received a level 'A' recommendation, required for real-world use. CONCLUSION Maternity PROMs identified in this systematic review had poor quality evidence for their measurement properties and lacked sufficient content validity, indicating a lack of woman-centricity in instrument development. Future research should prioritise women's voices in deciding what is relevant, comprehensive and comprehensible to measure, as this will impact overall validity and reliability and facilitate real-world use.
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Affiliation(s)
- M Battershell
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - H Vu
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - E J Callander
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - V Slavin
- Women-Newborn-Childrens Services, Gold Coast Health, QLD, Australia; School of Nursing and Midwifery, Griffith University, Meadowbrook, QLD, Australia
| | - A Carrandi
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - H Teede
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia; Endocrinology and Diabetes Units, Monash Health, VIC, Australia
| | - C Bull
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia.
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Sterling M, Andersen T, Carroll L, Connelly L, Côté P, Curatolo M, Grant G, Jull G, Kasch H, Ravn SL, MacDermid J, Malmström EM, Rebbeck T, Söderlund A, Treleaven J, Walton DM, Westergren H. Recommendations for a core outcome measurement set for clinical trials in whiplash associated disorders. Pain 2023; 164:2265-2272. [PMID: 37171189 DOI: 10.1097/j.pain.0000000000002926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/27/2023] [Indexed: 05/13/2023]
Abstract
ABSTRACT Inconsistent reporting of outcomes in clinical trials of treatments for whiplash associated disorders (WAD) hinders effective data pooling and conclusions about treatment effectiveness. A multidisciplinary International Steering Committee recently recommended 6 core outcome domains: Physical Functioning, Perceived Recovery, Work and Social Functioning, Psychological Functioning, Quality of Life and Pain. This study aimed to reach consensus and recommend a core outcome set (COS) representing each of the 6 domains. Forty-three patient-reported outcome measures (PROMs) were identified for Physical Functioning, 2 for perceived recovery, 37 for psychological functioning, 17 for quality of life, and 2 for pain intensity. They were appraised in 5 systematic reviews following COSMIN methodology. No PROMs of Work and Social Functioning in WAD were identified. No PROMs had undergone evaluation of content validity in patients with WAD, but some had moderate-to-high-quality evidence for sufficient internal structure. Based on these results, the International Steering Committee reached 100% consensus to recommend the following COS: Neck Disability Index or Whiplash Disability Questionnaire (Physical Functioning), the Global Rating of Change Scale (Perceived Recovery), one of the Pictorial Fear of Activity Scale-Cervical, Pain Self-Efficacy Questionnaire, Pain Catastrophizing Scale, Harvard Trauma Questionnaire, or Posttraumatic Diagnostic Scale (Psychological Functioning), EQ-5D-3L or SF-6D (Quality of Life), numeric pain rating scale or visual analogue scale (Pain), and single-item questions pertaining to current work status and percent of usual work (Work and Social Functioning). These recommendations reflect the current status of research of PROMs of the 6 core outcome domains and may be modified as evidence grows.
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Affiliation(s)
- Michele Sterling
- Recover Injury Research Centre, The University of Queensland, Herston, Australia
- NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Herston, Australia
| | - Tonny Andersen
- Department of Psychology, University of Southern Denmark, Odense M, Denmark
| | - Linda Carroll
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Luke Connelly
- NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Herston, Australia
- The University of Queensland Centre for the Business and Economics of Health, Sir Llew Edwards Building, St Lucia, Australia
- Departmento di Sociologia e Diritto Dell'Economia, The University of Bologna, Bologna, Italy
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
- Institute for Disability and Rehabilitation Research, Oshawa, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Michele Curatolo
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States
- Clinical Learning, Evidence and Research (CLEAR) Center for Musculoskeletal Disorders, Harborview Injury Preventions and Research Center (HIPRC), University of Washington, Seattle, WA, United States
| | - Genevieve Grant
- NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Herston, Australia
- Faculty of Law, Australian Centre for Justice Innovation (ACJI), Monash University, Melbourne, Australia
| | - Gwendolen Jull
- School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia
| | - Helge Kasch
- Research Unit, Spinal Cord Injury Centre of Western Denmark, Viborg, Denmark
- Department of Neurology, Regional Hospital of Viborg, Viborg, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Sophie Lykkegaard Ravn
- Department of Psychology, University of Southern Denmark, Odense M, Denmark
- Specialized Hospital for Polio and Accident Victims, Rødovre, Denmark
| | - Joy MacDermid
- School of Physical Therapy, Western University, London, ON Canada
- Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON Canada
| | - Eva-Maj Malmström
- Department of Pain Rehabilitation, Skåne University Hospital, Clinical Sciences, Lund University, Lund, Sweden
| | - Trudy Rebbeck
- NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Herston, Australia
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Anne Söderlund
- Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Julia Treleaven
- School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia
| | - David M Walton
- School of Physical Therapy, Western University, London, ON Canada
| | - Hans Westergren
- Department of Pain Rehabilitation, Skåne University Hospital, Clinical Sciences, Lund University, Lund, Sweden
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Jamjoom AB, Gahtani AY, Alzahrani MT, Baydhi LM, Albeshri AS, Sharab M. Arabic-Translated Versions of Patient-Reported Outcome Measures Utilized in Spine Research: A Review of Validated Studies. Cureus 2023; 15:e46303. [PMID: 37916239 PMCID: PMC10616682 DOI: 10.7759/cureus.46303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2023] [Indexed: 11/03/2023] Open
Abstract
Patient-reported outcome measures (PROMs) are standardized tools commonly applied in research and healthcare appraisal. Most were developed in English and the cross-cultural adaptation (CCA) and validation of their translated versions remain topics of contemporary research appeal. This review aimed to identify the Arabic-translated PROMs that were utilized in spine research and to assess the methodological qualities of their studies. The PubMed database was searched, and all relevant publications were identified. The CCA and measurement properties were assessed using the guidelines described by Oliveria and Terwee respectively. Thirty studies that validated the Arabic versions of 26 PROMs were found suitable. The tools that had the highest total citation numbers were Neck Disability Index, Ronald-Morris Disability Questionnaire, Oswestry Disability Index, Fear Avoidance Beliefs Questionnaire, Scoliosis Research Society-22, Back Beliefs Questionnaire, Quebec Back Pain Disability Scale, and McGill Pain Questionnaire-Short Form. The Arabic versions of Short Form-36 (SF-36), Visual Analogue Scale (VAS), and EuroQol-5D (EQ-5D) were not included due to lack of validation in spine research. All the articles were published from 2007 to 2023 (median 2019) and their journal's impact factor and citation numbers were relatively modest (mean 2 and 6.5 respectively). Most patients had low back pain (19 articles), were recruited from physiotherapy and rehabilitation departments (18 articles) and came from the Kingdom of Saudi Arabia (12 articles). The quality of the CCA of the Arabic versions was rated good in forward translation, synthesis, back translation, and expert committee review but less so in pretesting and submission. The measurement properties of the studies were considered good quality in internal consistency, reliability, structural validity and cross-cultural validity but less so in content validity, error measurement, responsiveness and floor/ceiling effect. In conclusion, with a few exceptions, most of the widely utilized PROMs in spine research have validated Arabic versions. The methodological quality of the studies was good apart from a few shortages that could be improved upon by further research. Work should be done to address the validation of Arabic versions of SF-36, VAS and EQ-5D in spine research. PROMs are valuable in systematizing subjective outcomes. Their usage in research and clinical settings in any validated language should be highly encouraged.
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Affiliation(s)
- Abdulhakim B Jamjoom
- Neurosurgery, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Abdulhadi Y Gahtani
- Neurosurgery, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Moajeb T Alzahrani
- Neurosurgery, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Laila M Baydhi
- Neurosurgery, King Abdulaziz Medical City Western Region, Jeddah, SAU
| | - Ahmad S Albeshri
- Neurosurgery, King Abdulaziz Medical City Western Region, Jeddah, SAU
| | - Momen Sharab
- Neurosurgery, King Abdulaziz Medical City Western Region, Jeddah, SAU
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10
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Close J, Vandercappellen J, King M, Hobart J. Measuring Fatigue in Multiple Sclerosis: There may be Trouble Ahead. Neurol Ther 2023; 12:1649-1668. [PMID: 37353721 PMCID: PMC10444927 DOI: 10.1007/s40120-023-00501-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 05/17/2023] [Indexed: 06/25/2023] Open
Abstract
INTRODUCTION Poorly developed patient-reported outcome measures (PROs) risk type-II errors (i.e. false negatives) in clinical trials, resulting in erroneous failure to achieve trial endpoints. Validity is a fundamental requirement of fit-for-purpose PROs, with the main determinant of validity being the PROs items, i.e. content validity. Here, we sought to identify fatigue PRO instruments used in multiple sclerosis (MS) studies and to assess the extent to which their development satisfied current content validity standards. METHODS We searched Embase® and Medline® for MS studies using fatigue-based PROs. Abstracts were screened, PROs identified, and their relevant development papers assessed against seven Consensus Standards for Measurement Instruments (COSMIN) criteria for content development. RESULTS From 3814 abstracts, 18 fatigue PROs met our inclusion criteria. Most PROs did not satisfy at least one COSMIN content validity standard. Frequent omissions during PRO development include: clearly defined constructs; conceptual frameworks; qualitative research in representative samples; and literature reviews. PRO development quality has improved significantly since FDA guidance was published (U = 10.0, p = 0.02). However, scatterplots and correlations between PRO COSMIN scores and citation frequency (rho = - 0.62) and clinical trials usage (rho = + 0.18) implied that PRO quality is unrelated to choice. COSMIN scores implied that the Fatigue Symptoms and Impact Questionnaire-Relapsing Multiple Sclerosis (FSIQ-RMS) and Neurological Fatigue Index-Multiple Sclerosis (NFI-MS) had the strongest evidence for adequate content validity. CONCLUSION Most existing fatigue PROs do not meet COSMIN content validity requirements. Although two PROs scored well on aggregate (NFI-MS and FSIQ-RMS), our subsequent evaluation of the item sets that generated their scores implied that both PROs have weaker content validity than COSMIN suggests. This indicates that COSMIN criteria require further development, and raises significant concerns about how we have measured one of the most common and burdensome MS symptoms. A detailed head-to-head psychometric evaluation is needed to determine the impact of different PRO development qualities and the implications of the problems implied by our analyses, on measurement performance.
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Affiliation(s)
- James Close
- Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK
| | | | | | - Jeremy Hobart
- Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK.
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11
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Sherwood LJ, Korakakis V, Mosler AB, Fortington L, Murphy MC. Quantifying Fear Avoidance Behaviors in People With Concussion: A COSMIN-Informed Systematic Review. J Orthop Sports Phys Ther 2023; 53:540-565. [PMID: 37561611 DOI: 10.2519/jospt.2023.11685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
OBJECTIVE: The validity of existing fear avoidance behavior patient-reported outcome measures (PROMs) for concussion is unknown. This study aims to (1) identify PROMs that assess fear avoidance behavior in individuals with concussion and (2) assess the measurement properties of these PROMs. DESIGN: A systematic review of outcome measurement instruments using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. LITERATURE SEARCH: We performed a systematic search of 7 databases. STUDY SELECTION CRITERIA: Studies were included if they assessed fear avoidance behavior (eg, kinesiophobia or cogniphobia) in participants with concussion, occurring in all settings (eg, sport, falls, assaults). DATA SYNTHESIS: Methodological quality of the PROMs was assessed using the COSMIN checklist, and the certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS: We identified 40 studies assessing fear avoidance. Four studies (n = 875 participants, representing 3 PROMs) were eligible for COSMIN assessment. Content validity for all PROMs was insufficient due to extreme risk of bias. The Fear Avoidance Short Form Scale demonstrated the greatest validity: moderate-certainty evidence for sufficient structural validity and internal consistency, and low-certainty evidence for measurement invariance. CONCLUSION: Current PROMs for measuring fear avoidance behaviors in people with concussion have insufficient content validity and should be used with caution in research and clinical practice. J Orthop Sports Phys Ther 2023;53(9):540-565. Epub: 10 August 2023. doi:10.2519/jospt.2023.11685.
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Jamjoom AB, Gahtani AY, Alzahrani MT, Albeshri AS, Sharab MA. Review of the Most Cited Patient-Reported Outcome Measure (PROM) Studies Published in the Neurospine Surgical Literature. Cureus 2023; 15:e44262. [PMID: 37772211 PMCID: PMC10523832 DOI: 10.7759/cureus.44262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
Patient-reported outcome measures (PROMs) are validated tools that are widely utilized in research and patient care. Their diversity, quality, and application remain matters of peak research interest. This article is a review of the PROMs that were utilized in high-impact publications in the neurospine surgical literature. The 50 most cited articles on the subject were selected and analysed. Most (42 articles) were published in spine journals and, in particular, in the journal Spine (Phila Pa 1976) (28 articles). A total of 34 PROMs were utilized, of which 24 were used only once in single studies. The four most common PROMs were Scoliosis Research Society-22 (SRS-22) (15 articles), Short Form-12 and Short Form-36 (SF-12 and SF-36) (11 articles), Ronald-Morris Disability Questionnaire (RMDQ) (nine articles), and Oswestry Disability Index (ODI) (five articles). Nineteen articles focused on validating translated versions of 11 PROMs to other languages. The languages that had the maximal number of tools translated to amongst the highly cited articles were Italian (six tools), Portuguese (four tools), German (three tools), and Japanese (three tools). The most common diagnoses and the PROMs used for them were back pain and cervical spine disorder (SF-12 and SF-36 (nine articles), RMDQ (eight articles), and ODI (five articles)), and idiopathic scoliosis (SRS-22) (14 articles)). The median (range) article citation number was 137 (78-675). The four most cited PROMs were SRS-22 (2,869), SF-12 and SF-36 (2,558), RMDQ (1,456), and ODI (852). Citation numbers were positively impacted by article age and participant number but not by tool type or clinical diagnosis. In conclusion, a wide range of PROMs was utilized in the 50 most cited publications in the neurospine surgical literature. The majority were disease-specific rather than generic and targeted particular spine pathology. Neurosurgical PROMs were under-represented amongst the most cited articles. Awareness of the PROMs used in high-impact studies may be helpful in tool selection in future research. PROMs are valuable in standardizing subjective outcomes. Their use in research and clinical settings in any validated language is highly encouraged.
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Affiliation(s)
- Abdulhakim B Jamjoom
- Neurosurgery, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Abdulhadi Y Gahtani
- Neurosurgery, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Moajeb T Alzahrani
- Neurosurgery, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Ahmad S Albeshri
- Neurosurgery, King Abdulaziz Medical City Western Region, Jeddah, SAU
| | - Momen A Sharab
- Neurosurgery, King Abdulaziz Medical City Western Region, Jeddah, SAU
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13
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Ben ÂJ, Pellekooren S, Bosmans JE, Ostelo RWJG, Maas ET, El Alili M, van Tulder MW, Huygen FJPM, Oosterhuis T, Apeldoorn AT, van Hooff ML, van Dongen JM. Mapping Oswestry Disability Index Responses to EQ-5D-3L Utility Values: Are Cost-Utility Results Valid? VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:873-882. [PMID: 36773782 DOI: 10.1016/j.jval.2023.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 12/23/2022] [Accepted: 01/19/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To develop and validate approaches for mapping Oswestry Disability Index responses to 3-level version of EQ-5D utility values and to evaluate the impact of using mapped utility values on cost-utility results compared with published regression models. METHODS Three response mapping approaches were developed in a random sample of 70% of 18 692 patients with low back pain: nonparametric approach (Non-p), nonparametric approach excluding logical inconsistencies (Non-peLI), and ordinal logistic regression (OLR). Performance was assessed in the remaining 30% using R-square (R2), root mean square error (RMSE), and mean absolute error (MAE). To evaluate whether MAEs and their 95% limits of agreement (LA) were clinically relevant, a minimally clinically important difference of 0.074 was used. Probabilities of cost-effectiveness estimated using observed and mapped utility values were compared in 2 economic evaluations. RESULTS The Non-p performed the best (R2 = 0.43; RMSE = 0.22; MAE = 0.03; 95% LA = -0.40 to 0.47) compared with the Non-peLI (R2 = 0.07; RMSE = 0.29; MAE = -0.15; 95% LA = -0.63 to 0.34) and OLR (R2 = 0.22; RMSE = 0.26; MAE = 0.02; 95% LA = -0.49 to 0.53). MAEs were lower than the minimally clinically important difference for the Non-p and OLR but not for the Non-peLI. Differences in probabilities of cost-effectiveness ranged from 1% to 4% (Non-p), 0.1% to 9% (Non-peLI), and 0.1% to 20% (OLR). CONCLUSIONS Results suggest that the developed response mapping approaches are not valid for estimating individual patients' 3-level version of EQ-5D utility values, and-depending on the approach-may considerably affect cost-utility results. The developed approaches did not perform better than previously published regression-based models and are therefore not recommended for use in economic evaluations.
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Affiliation(s)
- Ângela Jornada Ben
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Sylvia Pellekooren
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Department Human Movement Sciences, Faculty of Behavioral & Movement Sciences, Vrije Universiteit, Amsterdam, Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Raymond W J G Ostelo
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands
| | - Esther T Maas
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mohamed El Alili
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; National Health Care Institute, Diemen, The Netherlands
| | - Maurits W van Tulder
- Department Human Movement Sciences, Faculty of Behavioral & Movement Sciences, Vrije Universiteit, Amsterdam, Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands
| | | | - Teddy Oosterhuis
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Adri T Apeldoorn
- Rehabilitation Department, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands; Breederode Hogeschool, Rotterdam, Netherlands
| | - Miranda L van Hooff
- Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands; Department of Orthopedics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johanna M van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Li X, Zhao K, Li K, Wang W, Feng S, Wu J, He X, Xie S, Hu H, Fan J, Fu Q, Xie F. China Health Related Outcomes Measures (CHROME): development of a descriptive system to support cardiovascular disease specific preference-based measure for the Chinese population. Qual Life Res 2023:10.1007/s11136-023-03416-y. [PMID: 37119354 DOI: 10.1007/s11136-023-03416-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 05/01/2023]
Abstract
PURPOSE Preference-based measures have been increasingly recommended to measure health outcomes for economic evaluation. However, none of existing cardiovascular disease (CVD)-specific health-related quality of life (HRQoL) instruments are preference-based. This study aimed to develop the descriptive system of preference-based HRQoL instrument for Chinese patients with CVDs under the Initiative of China Health Related Outcomes Measures (CHROME). METHODS Qualitative face-to-face interviews were conducted with Chinese patients with CVDs. Content analysis was employed to generate candidate items for the instrument. Then expert consultation and cognitive debriefing interviews were conducted to guide further selection and revision of the items. RESULTS We interviewed 127 CVD patients with 67.7% being male and 63.8% living in the urban area. A hierarchical code book comprised of four themes, 20 categories, 62 sub-categories, and 207 codes, was developed. Candidate items were selected based on the criteria set by the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology and ISPOR PRO guidance. An online survey and meeting with an expert advisory panel (n = 15) followed by cognitive debriefing interviews with 20 patients and 13 physicians were conducted to further select and revise the candidate items. The descriptive system of CHROME-CVD consists of 14 items, namely frequency and severity of chest pain, chest tightness, palpitation, shortness of breath, dizziness, fatigue, appetite, sleeping, mobility, daily activities, depression, worry, and social relationship. Four or five level responses were selected based on cognitive debriefing results to each item. CONCLUSION The current study developed the descriptive system (items and response options) of CHROME-CVD, the future CVD-specific preference-based HRQoL instrument for Chinese CVD patients.
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Affiliation(s)
- Xue Li
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Kun Zhao
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kexin Li
- China Alliance for Rare Disease, Beijing, China
| | - Wenjun Wang
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China
| | - Siting Feng
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China
| | - Xiaoning He
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China
| | - Shitong Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Hao Hu
- Liaoning Institute of Basic Medicine, Liaoning, China
| | - Jing Fan
- National Center for Cardiovascular Diseases, Beijing, China
- Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qiang Fu
- China National Health Development Research Center, 9 Chegongzhuang Street, Xicheng District, Beijing, 100444, China.
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
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Karayannis NV, Smuck M, Law C, Mackey SC, Gross JJ, Darnall BD, Hush J. Self-reported physical function is strongly related to pain behavior and pain interference and weakly related to physical capacity in people with chronic low back pain. Musculoskelet Sci Pract 2023; 63:102721. [PMID: 36759316 PMCID: PMC10566747 DOI: 10.1016/j.msksp.2023.102721] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/15/2022] [Accepted: 01/16/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND Inclusion of self-reported and capacity-based measures may help to further elucidate the interactive link between how people think and move. OBJECTIVE To characterize the relationship between self-reported factors of physical function and pain with objective physical capacity measures. DESIGN Cross-sectional study of 328 adults with chronic low back pain (CLBP). METHOD Spearman correlations assessed the relationship between pairs of measures. Multiple linear regression models assessed the association between self-reported measures of physical function and the grouping of physical capacity measures. Self-reported measures included Roland Morris Disability Questionnaire (RMDQ), PROMIS Physical Function, Pain Behavior, and Pain Interference; Fear-Avoidance Beliefs Questionnaire (FABQ), Pain Catastrophizing Scale (PCS), and Chronic Pain Acceptance Questionnaire (CPAQ). Capacity measures included walking speed and endurance, lower extremity functional strength, lumbopelvic range of motion, and trunk endurance. RESULTS PROMIS Physical Function was directly and weakly correlated with walking speed (ρ = 0.26, 2-min walk) and inversely and weakly correlated with lower extremity strength (ρ = -0.29, 5x sit-to-stand). RMDQ was not correlated with any of the capacity-based measures. PROMIS Physical Function was inversely and moderately correlated with Pain Interference (ρ = -0.48) and Pain Behavior (ρ = -0.43), PCS (ρ = -0.36), and FABQ (ρ = -0.31). The RMDQ was strongly correlated with PROMIS Physical Function (ρ = -0.56), Pain Behavior (ρ = 0.51) and Pain Interference (ρ = 0.49); and moderately correlated with PCS (ρ = 0.37) and FABQ (ρ = 0.33). PROMIS Physical Function and RMDQ were not correlated with CPAQ. Lower scores on PROMIS Physical Function were weakly associated with lower measures of lower extremity strength (-0.30, 95% CI: -0.51 to -0.09, p = 0.005). Higher scores on RMDQ were also weakly associated with lower measures of lower extremity strength (0.26, 95% CI: 0.11 to 0.41, p = 0.001). CONCLUSIONS A strong association emerged between self-reported limitations in physical function, pain behavior, and pain interference. A weak association emerged between self-reported physical function and lower extremity strength.
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Affiliation(s)
| | | | | | | | | | | | - Julia Hush
- MacQuarie University, Sydney, Australia.
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Hernández-Lázaro H, Mingo-Gómez MT, Jiménez-del-Barrio S, Lahuerta-Martín S, Hernando-Garijo I, Medrano-de-la-Fuente R, Ceballos-Laita L. Researcher's Perspective on Musculoskeletal Conditions in Primary Care Physiotherapy Units through the International Classification of Functioning, Disability, and Health (ICF): A Scoping Review. Biomedicines 2023; 11:biomedicines11020290. [PMID: 36830831 PMCID: PMC9953260 DOI: 10.3390/biomedicines11020290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
(1) Background: Musculoskeletal disorders are the second cause of disability in the world. The International Classification of Functioning Disability and Health (ICF) is a tool for systematically describing functioning. Outcome measures for musculoskeletal disorders and functioning concepts embedded in them have not been described under the ICF paradigm. The objective of this scoping review was to identify ICF categories representing the researcher's perspective and to compare them with the ICF core set for post-acute musculoskeletal conditions. (2) Methods: This review was conducted as follows: (a) literature search using MEDLINE/PubMed, CINAHL, Web of Science, and Scopus databases; (b) study selection applying inclusion criteria (PICOS): musculoskeletal conditions in primary care, application of physiotherapy as a treatment, outcome measures related to functioning, and experimental or observational studies conducted in Western countries during the last 10 years; (c) extraction of relevant concepts; (d) linkage to the ICF; (e) frequency analysis; and (f) comparison with the ICF core set. (3) Results: From 540 studies identified, a total of 51 were included, and 108 outcome measures were extracted. In the ICF linking process, 147 ICF categories were identified. Analysis of data showed that 84.2% of the categories in the ICF core set for post-acute musculoskeletal conditions can be covered by the outcome measures analyzed. Sixty-eight relevant additional ICF categories were identified. (4) Conclusion: Outcome measures analyzed partially represent the ICF core set taken as a reference. The identification of additional categories calls into question the applicability of this core set in primary care physiotherapy units.
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Affiliation(s)
- Héctor Hernández-Lázaro
- Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
- Ólvega Primary Care Health Center (Soria, Spain), Soria Health Care Management, Castilla y León Regional Health Management (SACYL), 47007 Valladolid, Spain
| | - María Teresa Mingo-Gómez
- Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
| | - Sandra Jiménez-del-Barrio
- Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
- Correspondence:
| | | | - Ignacio Hernando-Garijo
- Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
| | - Ricardo Medrano-de-la-Fuente
- Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
| | - Luis Ceballos-Laita
- Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
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Bakaa N, Gross DP, Carlesso LC, MacDermid J, Thomas K, Slomp F, Rushton A, Miciak M, Smeets R, Rampersaud R, Nataraj A, Drew B, Markian P, Guha D, Cenic A, Macedo L. Presurgical rehabilitation program for patients with symptomatic lumbar spinal stenosis: A pilot randomized controlled trial protocol. Can J Pain 2022. [DOI: 10.1080/24740527.2022.2137009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
- Nora Bakaa
- School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Douglas P. Gross
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa C. Carlesso
- School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Joy MacDermid
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Kenneth Thomas
- Surgery and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Florence Slomp
- Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Alison Rushton
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Maxi Miciak
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Rob Smeets
- Maastricht, the Netherlands and CIR Revalidatie, Maastricht University, Eindhoven, The Netherlands
| | - Raja Rampersaud
- Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Nataraj
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Brian Drew
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Pahuta Markian
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Daipayan Guha
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Aleks Cenic
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Luciana Macedo
- School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
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Rashid M, Harish SP, Mathew J, Kalidas A, Raja K. Comprehensive rehabilitation outcome measurement scale (CROMS): development and preliminary validation of an interdisciplinary measure for rehabilitation outcomes. Health Qual Life Outcomes 2022; 20:160. [PMID: 36456958 PMCID: PMC9714173 DOI: 10.1186/s12955-022-02048-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 09/15/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Comprehensive and interdisciplinary measurement of rehabilitation outcome is an essential part of the assessment and prognosis of a patient. Thus, this requires substantial contributions from the patient, their family and the rehabilitation professional working with them. Moreover, the measurement tool should be comprehensive and must consider the cultural compatibility, cost efficiency and contextual factors of the region. METHODS The Comprehensive Rehabilitation Outcome Measurement Scale (CROMS) was developed through consensus and followed the Delphi process incorporating inputs from various rehabilitation professionals. The domains and items were finalized using Principal Component Analysis (PCA). The tool was validated in two native languages and back-translated considering the semantic equivalence of the scale. Intra-class correlation coefficient was performed to determine the agreement between the therapist and patient-reported scales. RESULTS The final CROMS carries 32 comprehensive items that can be completed by the person with disability and the professional team. CROMS compares well to similar items on FIM (l ICC of 0.93) and has good internal consistency with a Cronbach's Alpha of 0.92 for both patient and therapist reported measures. CONCLUSIONS The 32 item CROMS is a tool that can potentially be used to evaluate the functional independence of various patient populations, predominantly patients with neurological disabilities.
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Affiliation(s)
| | | | - Jerin Mathew
- grid.29980.3a0000 0004 1936 7830University of Otago, Dunedin, New Zealand
| | | | - Kavitha Raja
- JSS College of Physiotherapy, Mysuru, 570004 India
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Remus A, Lempke AFD, Wuytack F, Smith V. Outcome Measurement Instruments and Evidence-based Recommendations for Measurement of the Pelvic Girdle Pain Core Outcome Set (PGP-COS): A Systematic Review and Consensus Process. THE JOURNAL OF PAIN 2022; 23:2052-2069. [PMID: 36115519 DOI: 10.1016/j.jpain.2022.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 01/04/2023]
Abstract
This study provides evidence- and consensus-based recommendations for the instruments to measure the five Pelvic Girdle Pain Core Outcome Set (PGP-COS): pain frequency, pain intensity/severity, function/disability/activity limitation, health-related quality of life and fear avoidance. Studies evaluating measurement properties of instruments measuring any PGP-COS outcome in women with PGP were identified through a systematic search of MEDLINE, EMBASE and PEDro databases (inception-July 2021). The methodological quality of studies and quality of measurement properties were evaluated using the COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist. Quality criteria and the synthesized evidence were graded using the modified grading of recommendations, assessment, development, and evaluation (GRADE) approach. A consensus meeting with PGP stakeholders was then held to establish recommendations, based on the evidence, for the instruments that should be used to measure the PGP-COS. Ten instruments were identified from 17 studies. No instrument showed high quality evidence for all measurement properties and/or measured all PGP-COS outcomes. Based on current evidence and consensus, the Pelvic Girdle Questionnaire (PGQ), the Short Form-8 (SF-8) and the Fear Avoidance Beliefs Questionnaire (FABQ) are recommended for measuring the PGP-COS. Future research should establish additional measurement properties of instruments and to substantiate these recommendations.
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Affiliation(s)
- Alexandria Remus
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Alexandra F DeJong Lempke
- Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts; Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
| | - Francesca Wuytack
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland.
| | - Valerie Smith
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
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20
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Leon RJ, Lapkin S, Fields L, Moroney T. Developing a self-administered questionnaire: methods and considerations. Nurse Res 2022; 30:36-45. [PMID: 36043328 DOI: 10.7748/nr.2022.e1848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Using a structured process to develop a self-administered questionnaire provides a robust tool for collecting data that enhances the credibility of the results. Describing this process mitigates any complexity and confusion for the nurse researcher which can be generated by many sources of information that either lack detail or have complex statistical approaches. AIM To discuss the development of a self-administered questionnaire with a focus on face, content, construct validity and reliability testing. DISCUSSION Adopting a well-established, sequential, five-step approach ensures that important concepts of questionnaire development are addressed: assessing existing tools and qualitative data, if available; drafting of the questionnaire with consideration for question styles, comprehension, acquiescent bias and face validity; expert panel review to establish content validity and inter-rater reliability; pilot testing to assess construct validity; and exploratory factor analysis to establish reliability testing. This approach results in a robust and credible tool for collecting data. CONCLUSION This article provides nurse researchers with a structured process for developing self-administered questionnaires. IMPLICATIONS FOR PRACTICE Investing time and effort to assess a newly developed questionnaire for validity and reliability and consider question styles, comprehension and acquiescent bias results in an improved and strengthened tool for collecting data. This in turn enhances the quality and credibility of a study's findings.
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Affiliation(s)
- Rebecca J Leon
- People and culture, South Western Sydney Local Health District, Warwick Farm, New South Wales, Australia
| | - Samuel Lapkin
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Lorraine Fields
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Tracey Moroney
- Curtin School of Nursing, Curtin University, Perth, Western Australia, Australia
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21
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Takara KS, Alamino Pereira de Viveiro L, Moura PA, Marques Pasqual A, Pompeu JE. Roland-Morris disability questionnaire is bidimensional and has 16 items when applied to community-dwelling older adults with low back pain. Disabil Rehabil 2022:1-7. [PMID: 35798682 DOI: 10.1080/09638288.2022.2096127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To explore the evidence of the internal structure validity of the Roland-Morris Disability Questionnaire in older adults with low back pain. METHODS This was a cross-sectional study of psychometric testing involving 528 older adults with low back pain. Internal structure validity was explored by exploratory factor analysis and semi-confirmatory factor analysis. Reliability was verified using Kuder-Richardson Formula 20, Cronbach's alpha, and McDonald's omega. Replicability was observed by the generalized H index. RESULTS Roland-Morris Disability Questionnaire displayed two factors that assess "functional capacity" and "mobility". Eight items were excluded for presenting cross-loading (2 and 10), inadequate loading factors and communalities (18, 24, 13, and 12), or did not relate to the latent construct (15 and 22). Semi-confirmatory factor analysis indicated that the questionnaire had a good fitness model [X2 = 153.698 (p = 0.00001); RMSEA = 0.037; RMSR = 0.06; WRMR = 0.04; NNFI = 0.987; GFI = 0.979; AGFI = 0.971]. Reliability was acceptable (KR-20 = 0.79; Cronbach's alpha = 0.86; McDonald's Omega = 0.85), but replicability was poor in both factors (G-H factor 1 = 0.816-0.655; G-H factor 2 = 0.889-0.775). CONCLUSIONS The most appropriate version of the Roland-Morris Disability Questionnaire to apply to older adults with low back pain has 16 items and assesses functional capacity and mobility. IMPLICATIONS FOR REHABILITATIONThe RMDQ-16 is the most appropriate version of the RMDQ to use in older adults with LBP;The RMDQ-16 is bidimensional and assesses "functional capacity" and "mobility";The poor replicability of the RMDQ-16 indicates that it will probably not be stable across studies, but it can be useful in a clinical setting.
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Affiliation(s)
- Kelly Sayuri Takara
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Larissa Alamino Pereira de Viveiro
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Patricia Albuquerque Moura
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Amélia Marques Pasqual
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - José Eduardo Pompeu
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Outcome Domain and Measurement Instrument Reporting in Randomized Controlled Trials of Interventions for Lumbar Spinal Stenosis: A Systematic Review. J Orthop Sports Phys Ther 2022; 52:446-A2. [PMID: 35584024 DOI: 10.2519/jospt.2022.10879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To describe outcome measurement instruments and outcome domains in randomized controlled trials of any interventions for lumbar spinal stenosis (LSS). DESIGN Systematic review. LITERATURE SEARCH The Cochrane Central Register of Controlled Trials (CENTRAL) and PubMed were searched from inception to May 2020. STUDY SELECTION CRITERIA Trials were eligible if patients were diagnosed with LSS, with or without neurogenic claudication. Trials were eligible if they used at least 1 outcome measurement instrument. DATA SYNTHESIS Measurement instruments used in trials were extracted and then classified into outcome domains. We described the frequency of measurement instruments and outcome domains. RESULTS After study screening, 29 trials were included. In total, 54 different individual outcome measurement instruments were used. The Visual Analogue Scale (59%; n = 17) and the Oswestry Disability Index (52%; n = 15) were the most frequently used outcome measurement instruments in trials; function (90%; n = 26) and pain (62%; n = 18) were the most common outcome domains. CONCLUSION In total, 54 different measurement instruments were used in trials of interventions for LSS. This diverse range of observations contributes to outcome instrument heterogeneity between trials and impedes the analysis of data due to lack of comparability. The most common outcome domains assessed were pain and function, which will help inform a core outcome measure set for symptomatic LSS. J Orthop Sports Phys Ther 2022;52(7):446-456. Epub: 18 May 2022. doi:10.2519/jospt.2022.10879.
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Roland-Morris Disability Questionnaire, Oswestry Disability Index, and Quebec Back Pain Disability Scale: Which Has Superior Measurement Properties in Older Adults With Low Back Pain? J Orthop Sports Phys Ther 2022; 52:457-469. [PMID: 35584027 DOI: 10.2519/jospt.2022.10802] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To examine the validity, reliability, and responsiveness of 3 commonly used questionnaires for assessing physical function (ie, Oswestry Disability Index [ODI], Quebec Back Pain Disability Scale [QBPDS], and Roland-Morris Disability Questionnaire [RMDQ]) in older patients undergoing chiropractic care for low back pain (LBP). DESIGN Head-to-head clinimetric comparison. METHODS Patients completed the ODI, QBPDS, and RMDQ at baseline and after 2 weeks of treatment. Reliability was evaluated for internal consistency (Cronbach α), test-retest reliability (interclass correlation coefficient [ICC]), and measurement error (standard error of measurement and smallest detectable change [SDC]). Structural validity was evaluated through unidimensional confirmatory factor analysis, and construct validity was investigated by a priori hypotheses with other measures. Responsiveness was evaluated by testing a priori hypotheses using data at baseline and at 2-week follow-up. RESULTS Two hundred fourteen patients (53% males and 47% females) with a mean age of 66.2 years (standard deviation = 7.8 years) were included, of which 193 patients completed the 2-week follow-up for our responsiveness analysis. The RMDQ, ODI, and QBPDS showed sufficient internal consistency (Cronbach α of .89, .86, and .94, respectively) and test-retest reliability (ICC[2,1] of 0.85, 0.89, and 0.84, respectively). The SDC for the RMDQ was 6.9, for the ODI was 19.1, and for the QBPDS was 23.6, which are values larger than the minimal important change. None of the measures met all criteria for sufficient structural validity, but the RMDQ and ODI exhibited a partial unidimensional fit. The questionnaires had sufficient construct validity and responsiveness. CONCLUSION The ODI, QBPDS, and RMDQ have similar measurement properties in older adults with LBP. J Orthop Sports Phys Ther 2022;52(7):457-469. Epub: 18 May 2022. doi:10.2519/jospt.2022.10802.
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Kowalski KL, Lukacs MJ, Mistry J, Goodman M, Rushton AB. Physical functioning outcome measures in the lumbar spinal surgery population and measurement properties of the physical outcome measures: protocol for a systematic review. BMJ Open 2022; 12:e060950. [PMID: 35667717 PMCID: PMC9171219 DOI: 10.1136/bmjopen-2022-060950] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Low back pain can lead to substantial decline in physical functioning. For disabling pain not responsive to conservative management, surgical intervention can enhance physical functioning. Measurements of physical functioning include patient-reported outcome measures and physical outcome measures using evaluations of impairments, performance on a standardised task or activity in a natural environment. Selecting outcome measures with adequate measurement properties is fundamental to evaluating effectiveness of interventions. The purpose of this systematic review is to identify outcome measures (patient reported and physical) used to evaluate physical functioning (stage 1) and assess the measurement properties of physical outcome measures of physical functioning (stage 2) in the lumbar spinal surgery population. METHODS AND ANALYSIS This protocol aligns with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Using a two-staged approach, searches will be performed in MEDLINE, EMBASE, Health and Psychosocial Instruments, CINAHL, Web of Science, Scopus, PEDro and the grey literature from inception until 15 December 2021. Stage 1 will identify studies evaluating physical functioning with patient-reported or physical outcome measures in the lumbar spinal surgery population. Stage 2 will search for studies evaluating measurement properties (validity, reliability, responsiveness) of the physical outcome measures identified in stage 1 in the lumbar spinal surgery population. Two independent reviewers will evaluate studies for inclusion, extract data, assess risk of bias (COSMIN risk of bias tool and checklist) and quality of evidence (modified Grading of Recommendations Assessment, Development and Evaluation approach). Results for each measurement property per physical outcome measure will be quantitatively pooled if there is adequate clinical and methodological homogeneity or qualitatively synthesised if there is high heterogeneity in studies. ETHICS AND DISSEMINATION Ethics approval is not required. Results will be disseminated through peer-reviewed journal publication and conference presentation. PROSPERO REGISTRATION NUMBER CRD42021293880.
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Affiliation(s)
- Katie L Kowalski
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Michael J Lukacs
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Jai Mistry
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Physiotherapy, St George's Hospital, London, UK
| | - Maren Goodman
- Western Libraries, Western University, London, Ontario, Canada
| | - Alison B Rushton
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
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Fillipo R, Pruka K, Carvalho M, Horn ME, Moore J, Ramger B, Clewley D. Does the implementation of clinical practice guidelines for low back and neck pain by physical therapists improve patient outcomes? A systematic review. Implement Sci Commun 2022; 3:57. [PMID: 35659117 PMCID: PMC9164354 DOI: 10.1186/s43058-022-00305-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical therapy for neck and low back pain is highly variable despite the availability of clinical practice guidelines (CPG). This review aimed to determine the impact of CPG implementation on patient-level outcomes for spinal pain. Implementation strategies were also examined to determine prevalence and potential impact. METHODS Multiple databases were searched through April 2021 for studies assessing CPG implementation in physical therapy for neck and low back pain. Articles were screened for eligibility. The Modified Downs and Black checklist was utilized to determine study quality. Due to the heterogeneity between studies, a meta-analysis was not performed. RESULTS Twenty-one studies were included in this review. Implementation strategies were significantly varied between studies. Outcomes pertaining to healthcare utilization, pain, and physical functioning were assessed in relation to the implementation of CPGs. Multiple implementation strategies were identified, with Managing Quality as the most frequently utilized key implementation process. Findings indicate CPG implementation decreased healthcare utilization, but inconsistent results were found with physical functioning and pain outcomes. CONCLUSIONS CPG implementation appears to have a beneficial effect on healthcare utilization outcomes, but may not impact pain and physical functioning outcomes. Effective CPG implementation strategies remain unknown, though utilizing implementation framework may improve outcomes. More research is needed to determine the most effective implementation strategies and effects on pain and physical function outcomes.
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Affiliation(s)
- Rebecca Fillipo
- Department of Physical Therapy and Occupational Therapy, Duke University Health System, Durham, North Carolina, USA.
| | - Katie Pruka
- Department of Outpatient Rehabilitation, Duke University Health System, Durham, North Carolina, USA
| | - Marissa Carvalho
- Department of Physical Therapy and Occupational Therapy, Duke University Health System, Durham, North Carolina, USA
| | - Maggie E Horn
- Division of Doctor of Physical Therapy, Department of Orthopaedic Surgery, School of Medicine, Duke University, Durham, North Carolina, USA.,Department of Population Health Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Jordan Moore
- Department of Physical Therapy and Occupational Therapy, Duke University Health System, Durham, North Carolina, USA
| | - Benjamin Ramger
- Department of Outpatient Rehabilitation, Duke University Health System, Durham, North Carolina, USA
| | - Derek Clewley
- Division of Doctor of Physical Therapy, Department of Orthopaedic Surgery, School of Medicine, Duke University, Durham, North Carolina, USA
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Guo YJ, Hu XY, Li JY, Yang L. Effects of a WeChat-based individualized post-discharge rehabilitation program on patients with lumbar fusion surgery. J Back Musculoskelet Rehabil 2022; 35:545-557. [PMID: 34744066 DOI: 10.3233/bmr-200280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Exercise training after lumbar fusion surgery (LFS) is important for regaining the strength in the spinal muscles, pain management, and minimizing dysfunction. It may be prudent to evaluate technologies such as web-based chat and social media apps for increasing the efficacy of post-surgery interventions in LFS patients. OBJECTIVE To explore the effectiveness of a WeChat-based individualized post-discharge rehabilitation program in patients with LFS. METHODS Seventy-two eligible discharged LFS patients were enrolled from October 2018 to February 2019. The experimental group (36 cases) received a 10-week WeChat-based individualized rehabilitation program, while the control group (36 cases) received routine follow-up guidance. The outcomes were measured using the Exercise Compliance Questionnaire, Numerical Rating Scale, Oswestry Disability Index and Chinese version of the self-efficacy for exercise scale. RESULTS The analysis using generalized estimation equations method shows significant differences in the interaction effect of group*time in exercise compliance (Wald c2= 7.459, P< 0.05), group effect in pain (Wald c2= 5.811, P< 0.05) and self-efficacy (Wald c2= 16.383, P< 0.05). However, there was no significant difference between the experimental and control groups in the group effect in dysfunction improvement (Wald c2= 2.289, P> 0.05). CONCLUSIONS The WeChat-based rehabilitation intervention can improve exercise compliance and self-efficacy, and help achieve greater pain relief compared to the routine intervention. However, the WeChat-based intervention did not offer better improvement in the self-dysfunction in the post-discharge LFS patients.
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Affiliation(s)
- Yu-Jie Guo
- School of Medicine (School of Nursing), Nantong University, Nantong, Jiangsu, China
| | - Xiao-Yun Hu
- School of Pharmacy , Nanjing Medical University, Nanjing, Jiangsu, China.,School of Medicine (School of Nursing), Nantong University, Nantong, Jiangsu, China
| | - Jia-Yu Li
- School of Health and Nursing Science, Nantong Institute of Technology, Nantong, Jiangsu, China.,School of Medicine (School of Nursing), Nantong University, Nantong, Jiangsu, China
| | - Lei Yang
- First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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The patient-reported outcomes measurement information systems (PROMIS®) physical function and its derivative measures in adults: a systematic review of content validity. Qual Life Res 2022; 31:3317-3330. [PMID: 35622294 DOI: 10.1007/s11136-022-03151-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aims to systematically review and critically appraise the content validity of the adult versions of the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) item bank and its derivative measures in any adult population. METHODS MEDLINE and EMBASE were searched in October 2021 for studies on measurement properties of PROMIS-PF measures in an adult population. Studies were included if the study described the development of a PROMIS-PF measure or investigated its relevance, comprehensiveness, or comprehensibility. Assessment of the methodological quality of eligible studies, rating of results, and summarizing evidence was performed following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology for assessing content validity. A modified GRADE approach was used to determine the level of evidence. RESULTS Three development studies and eight studies on the content validity of one or more of the PROMIS-PF measures were identified. The methodological quality of most studies was rated doubtful. There was low to high level evidence for sufficient relevance, comprehensiveness, and comprehensibility of most PROMIS-PF measures for healthy seniors and various disease populations. We found low to moderate level evidence for insufficient relevance of PROMIS-PF measures for patients with conditions that affected only one body part, and insufficient comprehensibility of the PROMIS-PF measures for minority elderly. CONCLUSION Most PROMIS-PF measures demonstrate sufficient content validity in healthy seniors and various disease populations. However, the quality of this evidence is generally low to moderate, due to limitations in the methodological quality of the studies.
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Lukacs MJ, Kowalski KL, Peters N, Stanley M, Rushton AB. How is recovery defined and measured in patients with low back pain? Protocol for a mixed study systematic review. BMJ Open 2022; 12:e061475. [PMID: 35537787 PMCID: PMC9092166 DOI: 10.1136/bmjopen-2022-061475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION This protocol describes the methods for a mixed study systematic review aiming to explore the definitions and measurements of recovery in patients with low back pain, and how perspectives of recovery differ between patients and providers. This review will be the first to review the concept of recovery in patients with low back pain across both quantitative and qualitative literature. METHODS AND ANALYSIS This protocol has been designed and reported in line with Preferred Reporting Items of Systematic Reviews and Meta-Analyses Protocols. The following databases will be electronically searched from database inception until 30 November 2021: Medline, EMBASE, CINAHL, Cochrane, PEDro. Grey literature will be searched for through targeted searching of ProQuest Dissertations and Theses and handsearching of the references of all included studies. Studies will be included if they include a patient population of >50% with low back pain (with or without leg pain), and mention the concept of recovery within the abstract, methods or results. The Mixed Methods Appraisal Tool will be used for quality assessment of both quantitative and qualitative included studies. Two independent reviewers will conduct the search, screen titles/abstracts and extract relevant data from full texts. Discrepancies between reviewers will be settled by a third reviewer with spinal pain expertise. For syntheses, thematic analysis will be used to analyse both qualitative and quantitative investigations to explore meanings, measurement and perspectives of recovery from a diverse evidence base. There is no clinical trial associated with this protocol. ETHICS AND DISSEMINATION There are no ethical issues associated with this systematic review, and ethics approval was not required. Once completed, the results of this review will be published in a peer-reviewed journal within the realm of spinal pain to help guide future research inquiries. PROSPERO REGISTRATION NUMBER CRD42022295804.
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Affiliation(s)
- Michael J Lukacs
- School of Physical Therapy, Western University Faculty of Health Sciences, London, Ontario, Canada
| | - Katie L Kowalski
- School of Physical Therapy, Western University Faculty of Health Sciences, London, Ontario, Canada
| | - Nicole Peters
- School of Physical Therapy, Western University Faculty of Health Sciences, London, Ontario, Canada
| | - Meagan Stanley
- Western University Allyn and Betty Taylor Library, London, Ontario, Canada
| | - Alison B Rushton
- School of Physical Therapy, Western University Faculty of Health Sciences, London, Ontario, Canada
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Ghai V, Subramanian V, Jan H, Doumouchtsis SK. A systematic review highlighting poor-quality of evidence for Content Validity of Quality of Life (QoL) Instruments in Female Chronic Pelvic Pain (CPP). J Clin Epidemiol 2022; 149:1-11. [PMID: 35452795 DOI: 10.1016/j.jclinepi.2022.04.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/28/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To evaluate the content validity of 19 Patient Reported Outcome Measures (PROMs) used to measure QoL in women with CPP DESIGN AND SETTING: We searched EMBASE, MEDLINE, PsycINFO databases and Google Scholar from inception to August 2020. We included records describing the development or studies assessing content validity of PROMs. Two reviewers independently assessed the methodological quality of PROMs using the COSMIN checklist. Evidence was synthesised for relevance, comprehensiveness and comprehensibility. Quality of evidence was rated using a modified GRADE approach. MAIN RESULTS PROM development was inadequate for all instruments included in this review. No high-quality evidence ratings were found for relevance, comprehensiveness and comprehensibility. QoL was measured using generic instruments (68.42%, 13/19) rather than those specific to chronic pain (21.04%, 4/19) or pelvic pain (10.53%, 2/19). Quality of concept elicitation was inadequate for 90% of PROMs. Half of PROMs did not include patients in their development and only 40% were devised using a sample representative of the target population for which the PROM was developed. Cognitive interviews were conducted in one-fifth of PROMs and were mostly of inadequate/doubtful quality. CONCLUSION There is poor-quality of evidence for content validity of PROMs used to measure QoL in women with CPP.
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Affiliation(s)
- Vishalli Ghai
- Department of Obstetrics and Gynaecology, Epsom & St Helier University Hospitals NHS Trust, London, KT18 7EG, United Kingdom; St George's University of London, Crammer Terrace, London, SW17 0RE, United Kingdom.
| | - Venkatesh Subramanian
- Department of Obstetrics and Gynaecology, Epsom & St Helier University Hospitals NHS Trust, London, KT18 7EG, United Kingdom
| | - Haider Jan
- Department of Obstetrics and Gynaecology, Epsom & St Helier University Hospitals NHS Trust, London, KT18 7EG, United Kingdom
| | - Stergios K Doumouchtsis
- Department of Obstetrics and Gynaecology, Epsom & St Helier University Hospitals NHS Trust, London, KT18 7EG, United Kingdom; St George's University of London, Crammer Terrace, London, SW17 0RE, United Kingdom; Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, Athens, Greece; American University of the Caribbean, School of Medicine; Ross University, School of Medicine
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Carlton J, Powell PA. Measuring carer quality of life in Duchenne muscular dystrophy: a systematic review of the reliability and validity of self-report instruments using COSMIN. Health Qual Life Outcomes 2022; 20:57. [PMID: 35366897 PMCID: PMC8977045 DOI: 10.1186/s12955-022-01964-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/19/2022] [Indexed: 12/20/2022] Open
Abstract
Introduction Duchenne muscular dystrophy is a rare, progressive, life-limiting genetic neuromuscular condition that significantly impacts the quality of life of informal caregivers. Carer quality of life is measured using heterogeneous self-report scales, yet their suitability for Duchenne remains unclear. This review aimed to identify and evaluate the reliability and validity of quality of life instruments in Duchenne carers. Materials and methods Systematic searches were conducted in Embase, MEDLINE, CINAHL, PsycINFO, Cochrane Library and Google Scholar. Full research articles reporting data on multiple-item self-report quality of life instruments in informal Duchenne carers were included. Extracted evidence was qualitatively synthesised and evaluated, including risk of bias, against the Consensus-based Standards for the selection of health Measurement Instruments. Duchenne carer collaborators (N = 17) helped rate the instruments’ content validity. Results Thirty-one articles featuring thirty-two quality of life instruments were included. Content validity was rated as “inconsistent” based on very low quality evidence. For Duchenne carer collaborators, the best instrument was PedsQL Family Impact Module. Only one instrument had evidence for structural validity (rated “unsatisfactory”) and measurement invariance (rated “satisfactory”). Instruments received “satisfactory” ratings for internal consistency and mixed ratings for construct validity and responsiveness. There was no evidence for reliability, measurement error, or criterion validity. Discussion Instruments used to measure Duchenne carer quality of life have limited and often inconsistent supportive psychometric evidence. Further work must investigate instruments’ measurement properties in Duchenne carers and/or the development of new tools. In the interim, we recommend considering the PedsQL Family Impact Module based on Duchenne carer ratings. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-01964-4.
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MacDermid JC. ICF Linking and Cognitive Interviewing Are Complementary Methods for Optimizing Content Validity of Outcome Measures: An Integrated Methods Review. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:702596. [PMID: 36188847 PMCID: PMC9397968 DOI: 10.3389/fresc.2021.702596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/10/2021] [Indexed: 12/18/2022]
Abstract
Content validity is a fundamental requirement of outcome measures. After reviewing operational needs and existing definitions, content validity we as defined as: the extent to which a measure provides a comprehensive and true assessment of the key relevant elements of a specified construct or attribute across a defined range, clearly and equitably for a stated target audience and context. ICF linkage rules from 2002, 2005, and 2019 have provide increasingly clear processes for describing and evaluating content of outcome measures. ICF Core Sets provide international reference standards of the core constructs of importance for different health conditions. Both are important as reference standards during content validation. To summarize their use as reference standards, the following summary indicators were proposed: (1) Measure to ICF linkage, (2) Measure to (Brief or Comprehensive) Core Set Absolute Linkage, (3) Measure to (Brief or Comprehensive) Core Set Unique Linkage, (4) Core Set Representation, and (5) Core Set Unique Disability Representation. Methods to assess how respondents engage with content are needed to complement ICF-linking. Cognitive interviewing is an ideal method since it used to explore how respondents interpret and calibrate response to individual items on an outcome measure. We proposed a framework for classifying these responses: Clarity/Comprehension, Relevance, Inadequate response definition, Reference Point, Perspective modification, and Calibration Across Items. Our analysis of 24 manuscripts that used ICF linking for content validation since updated linking rules were published found that authors typically used linking to validate existing measures, involved multiple raters, used 2005 linking rules, summarized content at a concept level (e.g., impairment, activity, participation) and/or use core sets as a reference standard. Infrequently, ICF linking was used to create item pools/conceptual frameworks for new measures, applied the full scope of the 2019 linking rules, used summary indicators, or integrated ICF-linking with qualitative methods like cognitive interviews. We conclude that ICF linkage is a powerful tool for content validity during development or validation of PROM. Best practices include use of updated ICF linking rules, triangulation of ICF linking with participant assessments of clarity and relevance preferably obtained using cognitive interview methods, and application of defined summary indicators.
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Affiliation(s)
- Joy C. MacDermid
- Department of Surgery, School of Physical Therapy, Western University, London, ON, Canada
- Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada
- *Correspondence: Joy C. MacDermid
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Bushey MA, Wu J, Outcalt SD, Krebs EE, Ang D, Kline M, Yu Z, Bair MJ. Opioid use as a predictor of pain outcomes in Iraq and Afghanistan Veterans with chronic pain: Analysis of a randomized controlled trial. PAIN MEDICINE 2021; 22:2964-2970. [PMID: 34411252 DOI: 10.1093/pm/pnab237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Our objectives were to: 1) assess the relationship between self-reported opioid use and baseline demographics, clinical characteristics and pain outcomes; and 2) examine whether baseline opioid use moderated the intervention effect on outcomes at 9 months. DESIGN We conducted a secondary analysis of data from the Evaluation of Stepped Care for Chronic Pain (ESCAPE) trial, which found stepped-care to be effective for chronic pain in military veterans. SETTING A post-deployment clinic and 5 general medicine clinics at a Veteran Affairs Medical Center. SUBJECTS 241 veterans with chronic musculoskeletal pain; 220 with complete data at 9 months. METHODS Examination of baseline relationships and multivariable linear regression to examine baseline opioid use as a moderator of pain-related outcomes including Roland Morris Disability Questionnaire (RMDQ), Brief Pain Inventory (BPI) Interference scale, and Graded Chronic Pain Scale (GCPS) at 9 months. RESULTS Veterans reporting baseline opioid use (n = 80) had significantly worse RMDQ (16.0 ± 4.9 vs. 13.4 ± 4.2, P < 0.0001), GCPS (68.7 ± 12.0 vs. 65.0 ± 14.4, p = 0.049), BPI Interference (6.2 ± 2.2 vs. 5.0 ± 2.1, P < 0.0001), and depression (PHQ-9 12.5 ± 6.2 vs. 10.6 ± 5.7, p = 0.016) compared to veterans not reporting baseline opioid use. Using multivariable modeling we found that baseline opioid use moderated the intervention effect on pain-related disability (RMDQ) at 9 months (interaction Beta = -3.88, p = 0.0064), but not pain intensity or interference. CONCLUSIONS In a stepped-care trial for pain, patients reporting baseline opioid use had greater improvement in pain disability at 9 months compared to patients not reporting opioid use.
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Affiliation(s)
- Michael A Bushey
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jingwei Wu
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Samantha D Outcalt
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana, USA
| | - Erin E Krebs
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Dennis Ang
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Matthew Kline
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana, USA
| | - Zhangsheng Yu
- Department of Bioinformatics and Biostatistics, Shanghai Jiao Tong University, Shanghai, China
| | - Matthew J Bair
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana, USA
- Indiana University School of Medicine; Department of Medicine, Indianapolis, Indiana, USA
- Regenstrief Institute, Inc., Indianapolis, Indiana, USA
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Kersten R, Fikkers J, Wolterbeek N, Öner F, van Gaalen S. Are the Roland Morris Disability Questionnaire and Oswestry Disability Index interchangeable in patients after lumbar spinal fusion? J Back Musculoskelet Rehabil 2021; 34:605-611. [PMID: 33646141 PMCID: PMC8385504 DOI: 10.3233/bmr-200206] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Low back pain is a common health problem for which there are several treatment options. For optimizing clinical decision making, evaluation of treatments and research purposes it is important that health care professionals are able to evaluate the functional status of patients. Patient reported outcome measures (PROMs) are widely accepted and recommended. The Roland Morris Disability Questionnaire (RMDQ) and the Oswestry Disability Index (ODI) are the two mainly used condition-specific patient reported outcomes. Concerns regarding the content and structural validity and also the different scoring systems of these outcome measures makes comparison of treatment results difficult. OBJECTIVE Aim of this study was to determine if the RMDQ and ODI could be used exchangeable by assessing the correlation and comparing different measurement properties between the questionnaires. METHODS Clinical data from patients who participated in a multicenter RCT with 2 year follow-up after lumbar spinal fusion were used. Outcome measures were the RMDQ, ODI, Short Form 36 - Health Survey (SF-36), leg pain and back pain measured on a 0-100 mm visual analogue scale (VAS). Cronbach's alpha coefficients, Spearman correlation coefficients, multiple regression analysis and Bland-Altman plots were calculated. RESULTS three hundred and seventy-six completed questionnaires filled out by 87 patients were used. The ODI and RMDQ had both a good level of internal consistency. There was a very strong correlation between the RMDQ and the ODI (r= 0.87; p< 0.001), and between the VAS and both the ODI and RMDQ. However, the Bland-Altman plot indicated bad agreement between the ODI and RMDQ. CONCLUSIONS The RMDQ and ODI cannot be used interchangeably, nor is there a possibility of converting the score from one questionnaire to the other. However, leg pain and back pain seemed to be predictors for both the ODI and the RMDQ.
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Affiliation(s)
- R.F.M.R. Kersten
- Clinical Orthopedic Research Center – midden Nederland (CORC-mN), Department of Orthopedics, Diakonessenhuis Utrecht/Zeist, The Netherlands,Department of Orthopedics, University Medical Center Utrecht, Utrecht University, The Netherlands,Corresponding author: R.F.M.R. Kersten, Hospital CORC-mn Diakonessenhuis into UMC Utrecht, Department of Orthopedics, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Tel.: +31 88 755 5122; E-mail:
| | - J. Fikkers
- Department of Orthopedics, University Medical Center Utrecht, Utrecht University, The Netherlands,Department of Orthopedics, St. Antonius Hospital, Utrecht/Nieuwegein/Woerden, The Netherlands
| | - N. Wolterbeek
- Department of Orthopedics, St. Antonius Hospital, Utrecht/Nieuwegein/Woerden, The Netherlands
| | - F.C. Öner
- Department of Orthopedics, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - S.M. van Gaalen
- International Spine Center, Department of Orthopedics, Acibadem International Medical Center, Amsterdam, The Netherlands
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Heiberg Agerbeck A, Martiny FHJ, Jauernik CP, Due Bruun K, Rahbek OJ, Bissenbakker KH, Brodersen J. Validity of Current Assessment Tools Aiming to Measure the Affective Component of Pain: A Systematic Review. PATIENT-RELATED OUTCOME MEASURES 2021; 12:213-226. [PMID: 34262380 PMCID: PMC8274708 DOI: 10.2147/prom.s304950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/04/2021] [Indexed: 01/01/2023]
Abstract
The objective of this study was to identify patient-reported outcome measures (PROMs), which aim to measure the affective component of pain and to assess their content validity, unidimensionality, measurement invariance, and Internal consistency in patients with chronic pain. The study was reported according to the PRISMA guidelines. A protocol of the review was submitted to PROSPERO before data extraction. Eligible studies were any type of study that investigated at least one of the domains: PROM development, content validity, dimensionality, internal consistency, or measurement invariance of any type of scale that claimed to measure the affective component of pain among patients with chronic pain. The databases Medline, Embase, PsycINFO, and the Cochrane Library were searched for eligible studies. The database search was supplemented by looking for relevant articles in the reference list of included studies, ie backtracking. All included studies were assessed independently by two authors according to the “COSMIN methodology on Systematic Reviews of Patient-Reported Outcome Measures”. Descriptive data synthesis of the identified PROMs was conducted. The search yielded 11,242 titles of which 283 were assessed at the full-text level. Full-text screening led to the inclusion of 11 studies and an additional 28 studies were identified via backtracking, leading to the inclusion of 39 studies in total in the review. Included studies described the development and validity of 10 unique PROMs, all of which we assessed to have potentially inadequate content validity and doubtful psychometric properties. No studies reported whether the PROMs possessed invariant measurement properties. The existing PROMs measuring affective components of chronic pain potentially lack content validity and have inadequate psychometric measurement properties. There is a need for new PROMs measuring the affective component of chronic pain that possess high content validity and adequate psychometric measurement properties.
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Affiliation(s)
- Anders Heiberg Agerbeck
- The Section of General Practice and Research Unit for General Practice in Copenhagen, Copenhagen, Denmark.,The Research Unit for General Practice in Region Zealand, Copenhagen, Denmark.,Pain Research Group, Pain Centre, Odense University Hospital, Odense, Denmark
| | - Frederik Handberg Juul Martiny
- The Section of General Practice and Research Unit for General Practice in Copenhagen, Copenhagen, Denmark.,The Research Unit for General Practice in Region Zealand, Copenhagen, Denmark
| | - Christian Patrick Jauernik
- The Section of General Practice and Research Unit for General Practice in Copenhagen, Copenhagen, Denmark.,The Research Unit for General Practice in Region Zealand, Copenhagen, Denmark
| | - Karin Due Bruun
- Pain Research Group, Pain Centre, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Or Joseph Rahbek
- The Section of General Practice and Research Unit for General Practice in Copenhagen, Copenhagen, Denmark.,The Research Unit for General Practice in Region Zealand, Copenhagen, Denmark
| | - Kristine H Bissenbakker
- The Section of General Practice and Research Unit for General Practice in Copenhagen, Copenhagen, Denmark.,The Research Unit for General Practice in Region Zealand, Copenhagen, Denmark
| | - John Brodersen
- The Section of General Practice and Research Unit for General Practice in Copenhagen, Copenhagen, Denmark.,The Research Unit for General Practice in Region Zealand, Copenhagen, Denmark
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Glover PD, Gray H, Shanmugam S, McFadyen AK. Evaluating collaborative practice within community-based integrated health and social care teams: a systematic review of outcome measurement instruments. J Interprof Care 2021; 36:458-472. [PMID: 34219603 DOI: 10.1080/13561820.2021.1902292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Collaborative practice is a workforce priority for integrated health and social care systems internationally, requiring robust outcome measurement instruments (OMIs) to enable team development and good quality research. In this systematic review, we appraised self-administered OMIs that could be used to measure team-based collaborative practice within integrated health and social care teams in community settings. The most important measurement properties when selecting between OMIs are content and structural validity and internal consistency. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) systematic review method was modified to evaluate each OMI. For each measurement property, the methodological quality of individual studies and quality of each parameter were rated, and the level of evidence graded. A search strategy applied to 19 bibliographic databases identified 7 instruments that met eligibility criteria. A total of 6 development studies, 6 content validity studies, 8 studies for structural validity, and 10 for internal consistency were included. Only the shortened version of the Assessment of Interprofessional Team Collaboration Scale (ATICS-II) was rated as Sufficient for each measurement property with Very Low or Moderate quality evidence. Further validation of each OMI for use by community integrated teams is needed; studies evaluating relevance, comprehensibility and comprehensiveness are a priority.
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Affiliation(s)
| | - Heather Gray
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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36
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Comparison of patient- and clinician-reported outcome measures in lower back rehabilitation: introducing a new integrated performance measure (t2D). Qual Life Res 2021; 31:303-315. [PMID: 34129172 PMCID: PMC8800917 DOI: 10.1007/s11136-021-02905-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 01/07/2023]
Abstract
Purpose Patient- and clinician-reported outcome measures (PROMs, CROMs) are used in rehabilitation to evaluate and track the patient’s health status and recovery. However, controversy still exists regarding their relevance and validity when assessing a change in health status. Methods We retrospectively analyzed the changes in a CROM (Fingertip-To-Floor Test – FTF) and PROMs (ODI, HAQ-DI, NPRS, EQ5D) and the associations between these outcomes in 395 patients with lower back pain (57.2 ± 11.8 years, 49.1% female). We introduced a new way to measure and classify outcome performance using a distribution-based approach (t2D). Outcome measures were assessed at baseline and after 21 days of inpatient rehabilitation. Results Overall, the rehabilitation (Cohens d = 0.94) resulted in a large effect size outcome. Medium effect sizes were observed for FTF (d = 0.70) and PROMs (d > 0.50). Best performance rating was observed for pain (NPRS). We found that 13.9% of patients exhibited a deterioration in the PROMs, but only 2.3%, in the FTF. The correlation between the PROMs and FTF were low to moderate, with the highest identified for HAQ-DI (rho = 0.30–0.36); no significant correlations could be shown for changes. High consistency levels were observed among the performance scores (t2D) in 68.9% of the patients. Conclusions Different and complementary assessment modalities of PROMs and CROMs can be used as valuable tools in the clinical setting. Results from both types of measurements and individual performance assessments in patients provide a valid basis for the meaningful interpretation of the patients’ health outcomes. Trial registration. This clinical study was entered retrospectively on August 14, 2020 into the German Clinical Trials Register (DRKS, registration number: DRKS00022854).
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Carlton J, Leaviss J, Pouwer F, Hendrieckx C, Broadley MM, Clowes M, McCrimmon RJ, Heller SR, Speight J. The suitability of patient-reported outcome measures used to assess the impact of hypoglycaemia on quality of life in people with diabetes: a systematic review using COSMIN methods. Diabetologia 2021; 64:1213-1225. [PMID: 33528625 PMCID: PMC8099839 DOI: 10.1007/s00125-021-05382-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/19/2020] [Indexed: 11/26/2022]
Abstract
AIMS/HYPOTHESIS It is generally accepted that hypoglycaemia can negatively impact the quality of life (QoL) of people living with diabetes. However, the suitability of patient-reported outcome measures (PROMs) used to assess this impact is unclear. The aim of this systematic review was to identify PROMs used to assess the impact of hypoglycaemia on QoL and examine their quality and psychometric properties. METHODS Systematic searches (MEDLINE, EMBASE, PsycINFO, CINAHL and The Cochrane Library databases) were undertaken to identify published articles reporting on the development or validation of hypoglycaemia-specific PROMs used to assess the impact of hypoglycaemia on QoL (or domains of QoL) in adults with diabetes. A protocol was developed and registered with PROSPERO (registration no. CRD42019125153). Studies were assessed for inclusion at title/abstract stage by one reviewer. Full-text articles were scrutinised where considered relevant or potentially relevant or where doubt existed. Twenty per cent of articles were assessed by a second reviewer. PROMS were evaluated, according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines, and data were extracted independently by two reviewers against COSMIN criteria. Assessment of each PROM's content validity included reviewer ratings (N = 16) of relevance, comprehensiveness and comprehensibility: by researchers (n = 6); clinicians (n = 6); and adults with diabetes (n = 4). RESULTS Of the 214 PROMs used to assess the impact of hypoglycaemia on QoL (or domains of QoL), seven hypoglycaemia-specific PROMS were identified and subjected to full evaluation: the Fear of Hypoglycemia 15-item scale; the Hypoglycemia Fear Survey; the Hypoglycemia Fear Survey version II; the Hypoglycemia Fear Survey-II short-form; the Hypoglycemic Attitudes and Behavior Scale; the Hypoglycemic Confidence Scale; and the QoLHYPO questionnaire. Content validity was rated as 'inconsistent', with most as '(very) low' quality, while structural validity was deemed 'unsatisfactory'. Other measurement properties (e.g. reliability) varied, and evidence gaps were apparent across all PROMs. None of the identified studies addressed cross-cultural validity or measurement error. Criterion validity and responsiveness were not assessed due to the lack of a 'gold standard' measure of the impact of hypoglycaemia on QoL against which to compare the PROMS. CONCLUSIONS/INTERPRETATION None of the hypoglycaemia-specific PROMs identified had sufficient evidence to demonstrate satisfactory validity, reliability and responsiveness. All were limited in terms of content and structural validity, which restricts their utility for assessing the impact of hypoglycaemia on QoL in the clinic or research setting. Further research is needed to address the content validity of existing PROMs, or the development of new PROM(s), for the purpose of assessing the impact of hypoglycaemia on QoL. PROSPERO REGISTRATION CRD42019125153.
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Affiliation(s)
- Jill Carlton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
| | - Joanna Leaviss
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Steno Diabetes Center Odense, Odense, Denmark
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes (ACBRD), Melbourne, VIC, Australia
| | - Melanie M Broadley
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Mark Clowes
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Simon R Heller
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Jane Speight
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes (ACBRD), Melbourne, VIC, Australia
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Churruca K, Pomare C, Ellis LA, Long JC, Henderson SB, Murphy LED, Leahy CJ, Braithwaite J. Patient-reported outcome measures (PROMs): A review of generic and condition-specific measures and a discussion of trends and issues. Health Expect 2021; 24:1015-1024. [PMID: 33949755 PMCID: PMC8369118 DOI: 10.1111/hex.13254] [Citation(s) in RCA: 177] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/22/2021] [Accepted: 03/25/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are questionnaires that collect health outcomes directly from the people who experience them. This review critically synthesizes information on generic and selected condition-specific PROMs to describe trends and contemporary issues regarding their development, validation and application. METHODS We reviewed academic and grey literature on validated PROMs by searching databases, prominent websites, Google Scholar and Google Search. The identification of condition-specific PROMs was limited to common conditions and those with a high burden of disease (eg cancers, cardiovascular disorders). Trends and contemporary issues in the development, validation and application of PROMs were critically evaluated. RESULTS The search yielded 315 generic and condition-specific PROMs. The largest numbers of measures were identified for generic PROMs, musculoskeletal conditions and cancers. The earliest published PROMs were in mental health-related conditions. The number of PROMs grew substantially between 1980s and 2000s but slowed more recently. The number of publications discussing PROMs continues to increase. Issues identified include the use of computer-adaptive testing and increasing concerns about the appropriateness of using PROMs developed and validated for specific purposes (eg research) for other reasons (eg clinical decision making). CONCLUSIONS The term PROM is a relatively new designation for a range of measures that have existed since at least the 1960s. Although literature on PROMs continues to expand, challenges remain in selecting reliable and valid tools that are fit-for-purpose from the many existing instruments. PATIENT OR PUBLIC CONTRIBUTION Consumers were not directly involved in this review; however, its outcome will be used in programmes that engage and partner with consumers.
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Affiliation(s)
- Kate Churruca
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Chiara Pomare
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Janet C Long
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Suzanna B Henderson
- The Australian Commission on Safety and Quality in Health Care, Sydney, NSW, Australia
| | - Lisa E D Murphy
- The Australian Commission on Safety and Quality in Health Care, Sydney, NSW, Australia
| | - Christopher J Leahy
- The Australian Commission on Safety and Quality in Health Care, Sydney, NSW, Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
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Ibsen C, Schiøttz-Christensen B, Vinther Nielsen C, Hørder M, Schmidt AM, Maribo T. Assessment of functioning and disability in patients with low back pain - the low back pain assessment tool. Part 1: development. Disabil Rehabil 2021; 44:4841-4852. [PMID: 33945363 DOI: 10.1080/09638288.2021.1913648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE To present the process used to develop the low back pain (LBP) assessment tool including evaluation of the initial content validity of the tool. METHODS The development process comprised the elements: definition of construct and content, literature search, item generation, needs assessment, piloting, adaptations, design, and technical production. The LBP assessment tool was developed to assess the construct "functioning and disability" as defined by the International Classification of Functioning, Disability and Health (ICF). Involvement of patients and health professionals was essential. RESULTS The elements were collapsed into five steps. In total, 18 patients and 12 health professionals contributed to the content and the design of the tool. The LBP assessment tool covered all ICF components shared among 63 ICF categories. CONCLUSIONS This study presents the process used to develop the LBP assessment tool, which is the first tool to address all ICF components and integrate biopsychosocial perspectives provided by patients and health professionals in the same tool. Initial evaluation of content validity showed adequate reflection of the construct "functioning and disability". Further work on the way will evaluate comprehensiveness, acceptability, and degree of implementation of the LBP assessment tool to strengthen its use for clinical practice.Implications for RehabilitationA biopsychosocial and patients-centred approach is a strong foundation for identifying the many relevant aspects related to low back pain (LBP).Responding to a lack of tools to support a biopsychosocial and patients-centred approach the LBP assessment tool was developed using a robust, multi-step process with involvement of patients and health professionals.The LBP assessment tool is a strong candidate for a user-friendly tool to facilitate use of the International Classification of Functioning, Disability and Health in routine clinical practice.
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Affiliation(s)
- Charlotte Ibsen
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Aarhus, Denmark
| | - Berit Schiøttz-Christensen
- Spine Centre of Southern Denmark, Hospital Lillebaelt, Middelfart, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Claus Vinther Nielsen
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Aarhus, Denmark.,Regional Hospital West Jutland, Herning, Denmark
| | - Mogens Hørder
- Department of Public Health, Research Unit of User Perspectives, University of Southern Denmark, Odense, Denmark
| | - Anne Mette Schmidt
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Aarhus, Denmark.,SANO Aarhus, Aarhus, Denmark
| | - Thomas Maribo
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Aarhus, Denmark
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Franchignoni F, Giordano A, Monticone M. Construct validity of the Quebec Back Pain Disability Scale: a factor analytic and Rasch study. Eur J Phys Rehabil Med 2021; 57:600-606. [PMID: 33666389 DOI: 10.23736/s1973-9087.21.06502-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Studies on structural validity of the Quebec Back Pain Disability Scale (QBPDS) showed uncertain unidimensionality. AIM To investigate dimensionality and internal construct validity of the QBPDS, using advanced psychometric methods. DESIGN Secondary analysis of data from a cross-sectional observational study, SETTING: Outpatient rehabilitation hospital. POPULATION 201 patients with chronic Low Back Pain (40% men; mean age 48±12 years). METHODS Confirmatory (CFA) and then Exploratory Factor Analysis (EFA), and Rasch analysis were used. RESULTS CFA could not provide a satisfactory one-factor solution. Thus, according to a preliminary parallel analysis, two factor structures were examined: i) a single-factor solution, that showed good model fit according to Goodness of Fit Index and Comparative Fit Index, acceptable fit according to Root Mean Square Error of Approximation, and poor fit according to Standardized Root Mean Square of Residuals; ii) a bi-factor solution, both showing a good fit in all 4 indices. The Explained Common Variance index was 0.87. Thus, it was considered appropriate to apply Rasch analysis to our QBPDS data. Four items underfit the Rasch model and showed (two by two) local dependency. Removing these 4 misfitting items resulted in an acceptable fit to the Rasch model of the 16 remaining items. CONCLUSIONS All results pointed towards an essential unidimensionality of the QBPDS. Thus, we suggest to provisionally use the full QBPDS and its global score, pending further research on scale's construct validity. If the suboptimal performance of 4 items would be confirmed, the deletion of some of them could improve the metric quality of the scale. CLINICAL REHABILITATION IMPACT This study fills an evidence gap on important measurement properties of the QBPDS (namely, dimensionality and internal construct validity), thus representing a useful step towards the definition of the more suitable outcome measures for research and clinical practice in nonspecific chronic LBP.
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Affiliation(s)
- Franco Franchignoni
- Physical and Rehabilitation Medicine Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Institute of Tradate, Tradate, Varese, Italy
| | - Andrea Giordano
- Bioengineering Unit, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Veruno, Veruno, Novara, Italy
| | - Marco Monticone
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy - .,Neurorehabilitation Unit, Department of Neuroscience and Rehabilitation, G. Brotzu Hospital, Cagliari, Italy
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Abma IL, Butje BJD, Ten Klooster PM, van der Wees PJ. Measurement properties of the Dutch-Flemish patient-reported outcomes measurement information system (PROMIS) physical function item bank and instruments: a systematic review. Health Qual Life Outcomes 2021; 19:62. [PMID: 33627157 PMCID: PMC7905571 DOI: 10.1186/s12955-020-01647-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Limitations in physical functioning are a big concern especially for patients with chronic or musculoskeletal diseases. Therefore, physical functioning is often used as a core outcome of treatments. The generic patient-reported outcomes information system (PROMIS) physical function (PF) item bank has shown potential to measure PF with better precision, interpretability and lower respondent burden compared with traditional patient-reported outcome measures. This study provides an overview of the current evidence on the quality of the measurement properties of the translated Dutch-Flemish PROMIS-PF item bank and its subdomains, and their derived short forms and computer adaptive tests (CATs). METHODS PubMed was searched up to June 17th 2020 for validation studies of Dutch-Flemish PROMIS-PF in Dutch and Flemish adults. Quality assessment of the included studies was conducted using the COSMIN Risk of bias checklist. The COSMIN criteria for good measurement properties were used to judge the results of the studies, which were adjusted and added to where needed for this review, in the context of IRT instruments and item banks. The quality of evidence was summarized for each measurement property based on the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) approach. RESULTS Eleven studies were included, evaluating the PROMIS-PF item bank, the Upper Extremity (UE) subdomain, and/or their derived short forms and CATs in different clinical populations. There is evidence for sufficient structural validity, measurement precision, construct validity, and cross-cultural validity of the Dutch-Flemish PROMIS-PF item bank. The upper extremity subdomain item bank shows high quality evidence for structural validity and measurement precision. Content validity of these item banks has not been thoroughly demonstrated in a Dutch-Flemish population. Furthermore, the derived instruments have far less robust evidence: there are fewer validation studies available and none examined their performance as stand-alone administered instruments. CONCLUSIONS The first studies into the Dutch-Flemish PROMIS-PF item bank and the UE subdomain show promising results, with especially high quality evidence for sufficient structural validity and measurement precision. However, more studies, and with higher methodological quality, are needed to study the instruments derived from these item banks. These studies should also evaluate content validity, reliability and responsiveness.
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Affiliation(s)
- Inger L Abma
- Radboud University Medical Center, Radboud Institute of Health Sciences, IQ healthcare, Geert Grooteplein 21 (route 114), P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Bas J D Butje
- Radboud University Medical Center, Radboud Institute of Health Sciences, IQ healthcare, Geert Grooteplein 21 (route 114), P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Peter M Ten Klooster
- Department of Psychology, Health, and Technology, Centre for eHealth and Well-Being Research, University of Twente, Enschede, The Netherlands
| | - Philip J van der Wees
- Radboud University Medical Center, Radboud Institute of Health Sciences, IQ healthcare, Geert Grooteplein 21 (route 114), P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
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Chakravarty SD, Abell J, Leone-Perkins M, Orbai AM. A Novel Qualitative Study Assessing Patient-Reported Outcome Measures Among People Living with Psoriatic Arthritis or Ankylosing Spondylitis. Rheumatol Ther 2021; 8:609-620. [PMID: 33616863 PMCID: PMC7991046 DOI: 10.1007/s40744-021-00289-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/04/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Patient-reported outcome measures (PROMs) are used to capture patient perspectives in disease assessment. The objective of this study was to capture feedback about commonly used PROMs for spondyloarthritis (SpA) through semi-structured group discussions with individuals diagnosed with psoriatic arthritis (PsA) or ankylosing spondylitis (AS). The goal was to identify PROM content that most resonated with patient experiences and is therefore suitable for implementation in SpA clinical practice. Methods Semi-structured tasks and probes were designed to elicit qualitative patient feedback on several general health and disease-specific PROMs. During a series of in-person and telephone meetings, participants with PsA or AS were asked to identify content that resonated with them and to identify items that may not have captured their personal experiences living with their disease. Both individualized and small group review and concept elicitation were captured after participant review of PROMs. Results Both PsA and AS participants identified concepts that reflected their experiences living with a chronic disease, including fatigue, isolation, depression, inter-personal relationships, and sexual intimacy. Constructs incorporated into existing PROMs, such as pain, physical function, ability to perform activities of daily living, and stiffness, were also identified as important to participants. There were a few qualitative differences in participant perceptions about what they would like to see addressed by PROMs. For example, AS participants said that they would like to see PROMs elicit feedback about their experiences with pelvic and chest pain (e.g., as a result of chest inflammation/tenderness and chest expansion). PsA participants felt that PROMs should include measures about the embarrassment and shame that they experience as well as the impact of PsA on their daily lives. Conclusion Results of these qualitative assessments suggest that PROMs should be incorporated more frequently in outpatient settings to help improve the quality of decision-making conversations between patients and their healthcare providers. Participants indicated that constructs such as isolation, depression, fatigue, and relationships with others were critical to inform healthcare professionals about the patient experience of living with their disease.
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Affiliation(s)
- Soumya D Chakravarty
- Janssen Scientific Affairs, LLC, Horsham, PA, USA.
- Drexel University College of Medicine, Philadelphia, PA, USA.
| | - Jill Abell
- Janssen Scientific Affairs, LLC, Horsham, PA, USA
| | | | - Ana-Maria Orbai
- Psoriatic Arthritis Program, Johns Hopkins Arthritis Center, Baltimore, MD, USA
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Macedo LG, Hodges PW, Bostick G, Hancock M, Laberge M, Hanna S, Spadoni G, Gross A, Schneider J. Which Exercise for Low Back Pain? (WELBack) trial predicting response to exercise treatments for patients with low back pain: a validation randomised controlled trial protocol. BMJ Open 2021; 11:e042792. [PMID: 33472786 PMCID: PMC7818834 DOI: 10.1136/bmjopen-2020-042792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Exercise therapy is the most recommended treatment for chronic low back pain (LBP). Effect sizes for exercises are usually small to moderate and could be due to the heterogeneity of people presenting with LBP. Thus, if patients could be better matched to exercise based on individual factors, then the effects of treatment could be greater. A recently published study provided evidence of better outcomes when patients are matched to the appropriate exercise type. The study demonstrated that a 15-item questionnaire, the Lumbar Spine Instability Questionnaire (LSIQ), could identify patients who responded best to one of the two exercise approaches for LBP (motor control and graded activity). The primary aim of the current study isill be to evaluate whether preidentified baseline characteristics, including the LSIQ, can modify the response to two of the most common exercise therapies for non-specific LBP. Secondary aims include an economic evaluations with a cost-effectiveness analysis. METHODS AND ANALYSIS Participants (n=414) will be recruited by primary care professionals and randomised (1:1) to receive motor control exercises or graded activity. Participants will undergo 12 sessions of exercise therapy over an 8-week period. The primary outcome will be physical function at 2 months using the Oswestry Disability Index. Secondary outcomes will be pain intensity, function and quality of life measured at 2, 6 and 12 months. Potential effect modifiers will be the LSIQ, self-efficacy, coping strategies, kinesiophobia and measures of nociceptive pain and central sensitisation. We will construct linear mixed models with terms for participants (fixed), treatment group, predictor (potential effect modifier), treatment group×predictor (potential effect modifier), physiotherapists, treatment group×physiotherapists and baseline score for the dependent variable. ETHICS AND DISSEMINATION This study received ethics approval from the Hamilton Integrate Research Ethics Board. Results will be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04283409.
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Affiliation(s)
- Luciana G Macedo
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Paul W Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Geoff Bostick
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Mark Hancock
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Maude Laberge
- Faculty of Administration, Universite Laval, Quebec, Quebec, Canada
| | - Steven Hanna
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Greg Spadoni
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Anita Gross
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Julia Schneider
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Wingbermühle RW, Chiarotto A, Koes B, Heymans MW, van Trijffel E. Challenges and solutions in prognostic prediction models in spinal disorders. J Clin Epidemiol 2021; 132:125-130. [PMID: 33359321 DOI: 10.1016/j.jclinepi.2020.12.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/01/2020] [Accepted: 12/14/2020] [Indexed: 12/18/2022]
Abstract
Methodological shortcomings in prognostic modeling for patients with spinal disorders are highly common. This general commentary discusses methodological challenges related to the specific nature of this field. Five specific methodological challenges in prognostic modeling for patients with spinal disorders are presented with their potential solutions, as related to the choice of study participants, purpose of studies, limitations in measurements of outcomes and predictors, complexity of recovery predictions, and confusion of prognosis and treatment response. Large studies specifically designed for prognostic model research are needed, using standard baseline measurement sets, clearly describing participants' recruitment and accounting and correcting for measurement limitations.
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Affiliation(s)
- Roel W Wingbermühle
- SOMT University of Physiotherapy, Amersfoort, The Netherlands; Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - Alessandro Chiarotto
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Health Sciences, Faculty of Science, VU University, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Bart Koes
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Center for Muscle and Joint Health, University of Southern Denmark, Odense M, Denmark
| | - Martijn W Heymans
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Emiel van Trijffel
- SOMT University of Physiotherapy, Amersfoort, The Netherlands; Experimental Anatomy Research Department, Department of Physiotherapy, Human physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussels, Brussels, Belgium
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Patel KV, Amtmann D, Jensen MP, Smith SM, Veasley C, Turk DC. Clinical outcome assessment in clinical trials of chronic pain treatments. Pain Rep 2021; 6:e784. [PMID: 33521482 PMCID: PMC7837993 DOI: 10.1097/pr9.0000000000000784] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/14/2019] [Accepted: 08/01/2019] [Indexed: 12/13/2022] Open
Abstract
Clinical outcome assessments (COAs) measure outcomes that are meaningful to patients in clinical trials and are critical for determining whether a treatment is effective. The objectives of this study are to (1) describe the different types of COAs and provide an overview of key considerations for evaluating COAs, (2) review COAs and other outcome measures for chronic pain treatments that are recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) or other expert groups, and (3) review advances in understanding pain-related COAs that are relevant to clinical trials. The authors reviewed relevant articles, chapters, and guidance documents from the European Medicines Agency and U.S. Food and Drug Administration. Since the original core set of outcome measures were recommended by IMMPACT 14 years ago, several new advancements and publications relevant to the measurement or interpretation of COAs for chronic pain trials have emerged, presenting new research opportunities. Despite progress in the quality of measurement of several outcome domains for clinical trials of chronic pain, there remain some measurement challenges that require further methodological investigation.
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Affiliation(s)
- Kushang V. Patel
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Shannon M. Smith
- Departments of Anesthesiology and Perioperative Medicine, Obstetrics and Gynecology, and Psychiatry, University of Rochester, Rochester, NY, USA
| | | | - Dennis C. Turk
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
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Korakakis V, Kotsifaki A, Stefanakis M, Sotiralis Y, Whiteley R, Thorborg K. Evaluating lower limb tendinopathy with Victorian Institute of Sport Assessment (VISA) questionnaires: a systematic review shows very-low-quality evidence for their content and structural validity-part I. Knee Surg Sports Traumatol Arthrosc 2021; 29:2749-2764. [PMID: 34019117 PMCID: PMC8384789 DOI: 10.1007/s00167-021-06598-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/26/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE The Victorian Institute of Sport Assessment (Achilles tendon-VISA-A, greater trochanteric pain syndrome-VISA-G, proximal hamstring tendinopathy-VISA-H, patellar tendon-VISA-P) questionnaires are widely used in research and clinical practice; however, no systematic reviews have formally evaluated their content, structural, and cross-cultural validity evidence. The measurement properties referring to content, structural and cross-cultural validity of the VISA questionnaires were appraised and synthesized. METHODS The systematic review was conducted according to Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology. PubMed, Cochrane, CINAHL, EMBASE, Web of Science, SportsDiscus, grey literature, and reference lists were searched. Development studies and cross-cultural adaptations (12 languages) assessing content or structural validity of the VISA questionnaires were included and two reviewers assessed their methodological quality. Evidence for content (relevance, comprehensiveness, and comprehensibility), structural, and cross-cultural validity was synthesized. A modified Grading of Recommendations Assessment Development and Evaluation (GRADE) approach was applied to evidence synthesis. RESULTS The VISA-A presented very-low-quality evidence of sufficient relevance, insufficient comprehensiveness, and inconsistent comprehensibility. VISA-G displayed moderate-quality evidence for sufficient comprehensibility and very-low-quality evidence of sufficient relevance and comprehensiveness. The VISA-P presented very-low-quality evidence of sufficient relevance, insufficient comprehensiveness, and inconsistent comprehensibility, while VISA-H presented very-low evidence of insufficient content validity. VISA-A displayed low-quality evidence for structural validity concerning unidimensionality and internal structure, while VISA-H presented low-quality evidence of insufficient unidimensionality. The structural validity of VISA-G and VISA-P were indeterminate and inconsistent, respectively. Internal consistency for VISA-G, VISA-H, and VISA-P was indeterminate. No studies evaluated cross-cultural validity, while measurement invariance across sexes was assessed in one study. CONCLUSIONS Only very-low-quality evidence exists for the content and structural validity of VISA questionnaires when assessing the severity of symptoms and disability in patients with lower limb tendinopathies. LEVEL OF EVIDENCE IV. REGISTRATION PROSPERO reference-CRD42019126595.
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Affiliation(s)
- Vasileios Korakakis
- Aspetar, Orthopaedic and Sports Medicine Hospital, PO 29222, Doha, Qatar. .,Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece.
| | - Argyro Kotsifaki
- Aspetar, Orthopaedic and Sports Medicine Hospital, PO 29222, Doha, Qatar
| | - Manos Stefanakis
- School of Science, Program of Physiotherapy, University of Nicosia, Nicosia, Cyprus
| | - Yiannis Sotiralis
- Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece
| | - Rod Whiteley
- Aspetar, Orthopaedic and Sports Medicine Hospital, PO 29222, Doha, Qatar
| | - Kristian Thorborg
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center-Copenhagen (SORC-C), Amager-Hvidovre Hospital, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
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Effects of a movement control and tactile acuity training in patients with nonspecific chronic low back pain and control impairment - a randomised controlled pilot study. BMC Musculoskelet Disord 2020; 21:794. [PMID: 33256694 PMCID: PMC7702711 DOI: 10.1186/s12891-020-03727-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/16/2020] [Indexed: 12/04/2022] Open
Abstract
Background Nonspecific chronic low back pain (NSCLBP) is a heterogeneous condition that is associated with complex neuromuscular adaptations. Exercise is a widely administered treatment, but its effects are small to moderate. Tailoring patient-specific exercise treatments based on subgroup classification may improve patient outcomes. Objective In this randomised controlled pilot study, our objective was to compare the feasibility and possible effects of a specific sensorimotor treatment (SMT) with those of a general exercise (GE) programme on patients with NSCLBP and control impairment (CI). Methods Patients with NSCLBP and CI were randomised into an SMT or a GE programme spanning 6 sessions each. The feasibility criteria included the study design, assessments, interventions and magnitudes of effects, and costs. Adverse events were documented. Primary (pain, physical function, and quality of life) and secondary outcomes were assessed three times: twice at baseline (t1a and t1b) to estimate parameter stability and once after the intervention (t2). Results Two-hundred and twenty-seven patients were screened to include 34 participants with NSCLBP and CI. Both treatment programmes and the assessments seemed feasible because their durations and contents were perceived as adequate. The total cost per participant was €321. Two adverse events occurred (one not likely related to the SMT, one likely related to the GE intervention). The SMT showed a tendency for superior effects in terms of pain severity (SMT t1a 3.5, t2 1.1; GE t1a 3.0, t2 2.0), pain interference (SMT t1a 1.9, t2 0.4; GE t1a 1.5, t2 0.9), physical component of quality of life (SMT t1a 39, t2 46; GE t1a 45, t2 48), and movement control. Conclusions The SMT approach proposed in this study is feasible and should be tested thoroughly in future studies, possibly as an addition to GE. To ensure the detection of differences in pain severity between SMT and GE in patients with NSCLBP with 80% power, future studies should include 110 patients. If the current results are confirmed, SMT should be considered in interventions for patients with NSCLBP and CI. Trial registration Registered in the German Register for Clinical Trials (Trial registration date: November 11, 2016; Trial registration number: DRKS00011063; URL of trial registry record); retrospectively registered.
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Zapata-Ospina JP, García-Valencia J. Validity based on content: A challenge in health measurement scales. J Health Psychol 2020; 27:481-493. [PMID: 32945184 DOI: 10.1177/1359105320953477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Content-based validity can be defined as the evidence of the degree to which the items of an instrument represent the construct to be inferred. It is the initial and unavoidable step for evaluating other sources of validity. However, it is one of the least reported psychometric properties in development of health measurement scales. That is why it is considered a challenge that must be overcome with the recognition of its value. In this narrative review, the concept of content as evidence of validity is revised and methods for evaluation are synthesized with an algorithm.
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Affiliation(s)
- Juan Pablo Zapata-Ospina
- Institute of Medical Research, School of Medicine, Universidad de Antioquia, Academic Group of Clinical Epidemiology (GRAEPIC), Medellín, Antioquia, Colombia
| | - Jenny García-Valencia
- Institute of Medical Research, School of Medicine, Universidad de Antioquia, Academic Group of Clinical Epidemiology (GRAEPIC), Medellín, Antioquia, Colombia
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Wittkowski A, Vatter S, Muhinyi A, Garrett C, Henderson M. Measuring bonding or attachment in the parent-infant-relationship: A systematic review of parent-report assessment measures, their psychometric properties and clinical utility. Clin Psychol Rev 2020; 82:101906. [PMID: 32977111 PMCID: PMC7695805 DOI: 10.1016/j.cpr.2020.101906] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 08/02/2020] [Accepted: 08/21/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Meaningful, valid and reliable self-report measures can facilitate the identification of important parent-infant-relationship factors, relevant intervention development and subsequent evaluation in community and clinical contexts. We aimed at identifying all available parent-report measures of the parent-infant-relationship or bond and to appraise their psychometric and clinimetric properties. METHOD A systematic review (PROSPERO: CRD42017078512) was conducted using the, 2018 COSMIN criteria. Eight electronic databases were searched. Papers describing the development of self-report measures of the parent-infant-bond, attachment or relationship from pregnancy until two years postpartum or the assessment of their psychometric properties were included. RESULTS Sixty-five articles evaluating 17 original measures and 13 modified versions were identified and reviewed. The studies' methodological quality (risk of bias) varied between 'very good' and 'inadequate' depending on the measurement property assessed; however, scale development studies were mostly of 'inadequate' quality. Although most measures had good clinical utility, the psychometric evaluation of their properties was largely poor. The original or modified versions of the Postpartum Bonding Questionnaire collectively received the strongest psychometric evaluation ratings with high quality of evidence. CONCLUSIONS This novel review revealed that only a few antenatal and postnatal measures demonstrated adequate psychometric properties. Further studies are needed to determine the most robust perinatal measures for researchers and clinicians.
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Affiliation(s)
- A Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK; Greater Manchester Mental Health NHS Foundation Trust, Department of Clinical Psychology, Laureate House, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
| | - S Vatter
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - A Muhinyi
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - C Garrett
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - M Henderson
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, 200 Renfield Street, Glasgow G2 3AX, UK
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Powell PA, Carlton J, Woods HB, Mazzone P. Measuring quality of life in Duchenne muscular dystrophy: a systematic review of the content and structural validity of commonly used instruments. Health Qual Life Outcomes 2020; 18:263. [PMID: 32746836 PMCID: PMC7397669 DOI: 10.1186/s12955-020-01511-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 07/24/2020] [Indexed: 12/27/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is an inherited X-linked neuromuscular disorder. A number of questionnaires are available to assess quality of life in DMD, but there are concerns about their validity. This systematic review aimed to appraise critically the content and structural validity of quality of life instruments for DMD. Five databases (EMBASE, MEDLINE, CINAHL, PsycINFO, and Cochrane Library) were searched, with supplementary searches in Google Scholar. We included articles with evidence on the content and/or structural validity of quality of life instruments in DMD, and/or instrument development. Evidence was evaluated against the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. Fifty five articles featured a questionnaire assessing quality of life in DMD. Forty instruments were extracted and 26 underwent assessment. Forty-one articles contained evidence on content or structural validity (including 37 development papers). Most instruments demonstrated low quality evidence and unsatisfactory or inconsistent validity in DMD, with the majority not featuring direct validation studies in this population. Only KIDSCREEN received an adequate rating for instrument design and a satisfactory result for content validity based on its development, yet, like the majority of PROMs, the measure has not been directly validated for use in DMD. Further research is needed on the validity of quality of life instruments in DMD, including content and structural validity studies in this population.
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Affiliation(s)
- Philip A Powell
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. .,Department of Economics, University of Sheffield, 9 Mappin Street, Sheffield, S1 4DT, UK.
| | - Jill Carlton
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Helen Buckley Woods
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Paolo Mazzone
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
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