Authors: C D Fankhauser U Mutter E Aghayev A F Mannion
Publish Date: 2011/08/20
Volume: 21, Issue: 1, Pages: 101-114
Abstract
Patientorientated outcome questionnaires are essential to evaluate treatment success To compare different treatments hospitals and surgeons standardised questionnaires are required The present study examined the validity and responsiveness of the Core Outcome Measurement Index for neck pain COMIneck a short multidimensional outcome instrumentQuestionnaires were completed by patients with degenerative problems of the cervical spine undergoing cervical disc arthroplasty before N = 89 and 3 months after N = 75 surgery The questionnaires comprised the EuroQolFive Dimension EQ5D the North American Spine Society Cervical Spine Outcome Assessment Instrument NASScervical and the COMIneckThe COMI and NASScervical scores displayed no notable floor or ceiling effects at any time point whereas for the EQ5D the highest or lowest values were reached in around 325 of patients at followup With one exception symptomspecific wellbeing the individual COMI items and the COMI summary score correlated to the expected extent R = 04–08 with the scores of the chosen reference questionnaires The area under the curve AUC generated by ROC analysis was significantly higher for the COMI 096 than for any other instrument/subscale when self reported treatment outcome was used as the external criterion dichotomised as “good” operation helped a lot/helped versus “poor” operation helped only a little/didn’t help/made things worse The COMI had a high effect size standardised response mean SRM 234 for the good global outcome group and a low SRM for the poor outcome group 034 The EQ5D and the NASScervical lacked this ability to differentiate between the two groups showing less distinct SRMs for good and poor outcome groupsThis study provides evidence that the COMIneck is a valid and responsive questionnaire in the population of patients examined Further investigations should examine its applicability in other patient groups with less severe neck pain or undergoing other treatment modalities
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