PMID- 17064410
OWN - NLM
STAT- MEDLINE
DCOM- 20061212
LR  - 20220410
IS  - 1471-2474 (Electronic)
IS  - 1471-2474 (Linking)
VI  - 7
DP  - 2006 Oct 25
TI  - Responsiveness and minimal clinically important difference for pain and 
      disability instruments in low back pain patients.
PG  - 82
AB  - BACKGROUND: The choice of an evaluative instrument has been hampered by the lack 
      of head-to-head comparisons of responsiveness and the minimal clinically 
      important difference (MCID) in subpopulations of low back pain (LBP). The 
      objective of this study was to concurrently compare responsiveness and MCID for 
      commonly used pain scales and functional instruments in four subpopulations of 
      LBP patients. METHODS: The Danish versions of the Oswestry Disability Index 
      (ODI), the 23-item Roland Morris Disability Questionnaire (RMQ), the physical 
      function and bodily pain subscales of the SF36, the Low Back Pain Rating Scale 
      (LBPRS) and a numerical rating scale for pain (0-10) were completed by 191 
      patients from the primary and secondary sectors of the Danish health care system. 
      Clinical change was estimated using a 7-point transition question and a numeric 
      rating scale for importance. Responsiveness was operationalized using 
      standardized response mean (SRM), area under the receiver operating 
      characteristic curve (ROC), and cut-point analysis. Subpopulation analyses were 
      carried out on primary and secondary sector patients with LBP only or leg pain 
      +/- LBP. RESULTS: RMQ was the most responsive instrument in primary and secondary 
      sector patients with LBP only (SRM = 0.5-1.4; ROC = 0.75-0.94) whereas ODI and 
      RMQ showed almost similar responsiveness in primary and secondary sector patients 
      with leg pain (ODI: SRM = 0.4-0.9; ROC = 0.76-0.89; RMQ: SRM = 0.3-0.9; ROC = 
      0.72-0.88). In improved patients, the RMQ was more responsive in primary and 
      secondary sector patients and LBP only patients (SRM = 1.3-1.7) while the RMQ and 
      ODI were equally responsive in leg pain patients (SRM = 1.3 and 1.2 
      respectively). All pain measures demonstrated almost equal responsiveness. The 
      MCID increased with increasing baseline score in primary sector and LBP only 
      patients but was only marginally affected by patient entry point and pain 
      location. The MCID of the percentage change score remained constant for the ODI 
      (51%) and RMQ (38%) specifically and differed in the subpopulations. CONCLUSION: 
      RMQ is suitable for measuring change in LBP only patients and both ODI and RMQ 
      are suitable for leg pain patients irrespectively of patient entry point. The 
      MCID is baseline score dependent but only in certain subpopulations. Relative 
      change measured using the ODI and RMQ was not affected by baseline score when 
      patients quantified an important improvement.
FAU - Lauridsen, Henrik H
AU  - Lauridsen HH
AD  - Clinical Locomotion Science, Institute of Sports Science and Clinical 
      Biomechanics, University of Southern Denmark, Odense, Denmark. 
      hlauridsen@health.sdu.dk
FAU - Hartvigsen, Jan
AU  - Hartvigsen J
FAU - Manniche, Claus
AU  - Manniche C
FAU - Korsholm, Lars
AU  - Korsholm L
FAU - Grunnet-Nilsson, Niels
AU  - Grunnet-Nilsson N
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20061025
PL  - England
TA  - BMC Musculoskelet Disord
JT  - BMC musculoskeletal disorders
JID - 100968565
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Area Under Curve
MH  - Chronic Disease
MH  - Cohort Studies
MH  - Denmark
MH  - *Disability Evaluation
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Low Back Pain/*classification
MH  - Male
MH  - Middle Aged
MH  - *Pain Measurement
MH  - Prospective Studies
MH  - ROC Curve
MH  - Sciatica/classification
MH  - Sensitivity and Specificity
MH  - Surveys and Questionnaires
PMC - PMC1635558
EDAT- 2006/10/27 09:00
MHDA- 2006/12/13 09:00
PMCR- 2006/10/25
CRDT- 2006/10/27 09:00
PHST- 2006/05/15 00:00 [received]
PHST- 2006/10/25 00:00 [accepted]
PHST- 2006/10/27 09:00 [pubmed]
PHST- 2006/12/13 09:00 [medline]
PHST- 2006/10/27 09:00 [entrez]
PHST- 2006/10/25 00:00 [pmc-release]
AID - 1471-2474-7-82 [pii]
AID - 10.1186/1471-2474-7-82 [doi]
PST - epublish
SO  - BMC Musculoskelet Disord. 2006 Oct 25;7:82. doi: 10.1186/1471-2474-7-82.