Correlation between the Oswestry Disability Index and the 4-item short forms for physical function and pain interference from PROMIS

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OBJECTIVE

The Oswestry Disability Index (ODI) is one of the most commonly used patient-reported outcome instruments, but completion of this 10-question survey can be cumbersome. Tools from the Patient-Reported Outcomes Measurement Information System (PROMIS) are an alternative, and potentially more efficient, means of assessing physical, mental, and social outcomes in spine surgery. Authors of this retrospective study assessed whether scores on the 4-item surveys of function and pain from the PROMIS initiative correlate with those on the ODI in lumbar spine surgery.

METHODS

Patients evaluated in the adult neurosurgery spine clinic at a single institution completed the ODI, PROMIS Short Form v2.0 Physical Function 4a (PROMIS PF), and PROMIS Short Form v1.0 Pain Interference 4a (PROMIS PI) at various time points in their care. Score data were retrospectively analyzed using linear regressions with calculation of the Pearson correlation coefficient.

RESULTS

Three hundred forty-three sets of surveys (ODI, PROMIS PF, and PROMIS PI) were obtained from patients across initial visits (n = 147), 3-month follow-ups (n = 107), 12-month follow-ups (n = 52), and 24-month follow-ups (n = 37). ODI scores strongly correlated with PROMIS PF t-scores at baseline (r = −0.72, p < 0.0001), 3 months (r = −0.79, p < 0.0001), 12 months (r = −0.85, p < 0.0001), and 24 months (r = −0.89, p < 0.0001). ODI scores also correlated strongly with PROMIS PI t-scores at baseline (r = 0.71, p < 0.0001), at 3 months (r = 0.82, p < 0.0001), at 12 months (r = 0.86, p < 0.0001), and at 24 months (r = 0.88, p < 0.0001). Changes in ODI scores moderately correlated with changes in PROMIS PF t-scores (r = −0.68, p = 0.0003) and changes in PROMIS PI t-scores (r = 0.57, p = 0.0047) at 3 months postoperatively.

CONCLUSIONS

A strong correlation was found between the ODI and the 4-item PROMIS PF/PI at isolated time points for patients undergoing lumbar spine surgery. Large cohort studies are needed to determine longitudinal accuracy and precision and to assess possible benefits of time savings and improved rates of survey completion.

ABBREVIATIONS CAT = computer-adaptive testing; ODI = Oswestry Disability Index; PRO = patient-reported outcome; PROMIS = Patient-Reported Outcomes Measurement Information System; PROMIS PF = PROMIS Short Form v2.0 Physical Function 4a; PROMIS PI = PROMIS Short Form v1.0 Pain Interference 4a.

Article Information

Correspondence Paul Park: University of Michigan, Ann Arbor, MI. ppark@med.umich.edu.

INCLUDE WHEN CITING Published online August 9, 2019; DOI: 10.3171/2019.5.SPINE19400.

Disclosures Dr. Chang has consulted for Globus Medical, K2M, and SpineGuard and has received research funding from Medtronic. Dr. Schwalb has consulted for Bluerock and Guidepoint, received research support from Medtronic, and received salary support from Blue Cross Blue Shield of Michigan. Dr. Abdulhak has been a consultant for Seaspine and Ulrich Medical USA and has received clinical or research support from Blue Cross Blue Shield of Michigan for the study described. Dr. Park is a consultant for Allosource, Globus Medical, NuVasive, and Medtronic and has received royalties from Globus Medical and research support from Pfizer and Vertex.

© AANS, except where prohibited by US copyright law.

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Figures

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    Scatter plots of ODI scores and PROMIS PF t-scores (upper) and ODI scores and PROMIS PI t-scores (lower) at baseline. The correlation noted in the inset is the Pearson correlation coefficient.

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    Scatter plots of ODI scores and PROMIS PF t-scores (upper) and ODI scores and PROMIS PI t-scores (lower) at 3 months postoperatively. The correlation noted in the inset is the Pearson correlation coefficient.

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    Scatter plots of ODI scores and PROMIS PF t-scores (upper) and ODI scores and PROMIS PI t-scores (lower) at 12 months postoperatively. The correlation noted in the inset is the Pearson correlation coefficient.

  • View in gallery

    Scatter plots of ODI scores and PROMIS PF t-scores (upper) and ODI scores and PROMIS PI t-scores (lower) at 24 months postoperatively. The correlation noted in the inset is the Pearson correlation coefficient.

References

  • 1

    Ader DN: Developing the Patient-Reported Outcomes Measurement Information System (PROMIS). Med Care 45:S1S22007

  • 2

    Boody BSBhatt SMazmudar ASHsu WKRothrock NEPatel AA: Validation of Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests in cervical spine surgery. J Neurosurg Spine 28:2682792018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Brodke DSGoz VVoss MWLawrence BDSpiker WRHung M: PROMIS PF CAT outperforms the ODI and SF-36 physical function domain in spine patients. Spine (Phila Pa 1976) 42:9219292017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Cella DYount SRothrock NGershon RCook KReeve B: The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH Roadmap cooperative group during its first two years. Med Care 45 (5 Suppl 1):S3S112007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5

    Chiarotto ABoers MDeyo RABuchbinder RCorbin TPCosta LOP: Core outcome measurement instruments for clinical trials in nonspecific low back pain. Pain 159:4814952018

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Davidson M: Rasch analysis of three versions of the Oswestry Disability Questionnaire. Man Ther 13:2222312008

  • 7

    Fairbank JC: Why are there different versions of the Oswestry Disability Index? J Neurosurg Spine 20:83862014

  • 8

    Fairbank JCCouper JDavies JBO’Brien JP: The Oswestry low back pain disability questionnaire. Physiotherapy 66:2712731980

  • 9

    Fairbank JCPynsent PB: The Oswestry Disability Index. Spine (Phila Pa 1976) 25:294029522000

  • 10

    Gibbons LEFeldman BJCrane HMMugavero MWillig JHPatrick D: Migrating from a legacy fixed-format measure to CAT administration: calibrating the PHQ-9 to the PROMIS depression measures. Qual Life Res 20:134913572011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Guzman JZCutler HSConnolly JSkovrlj BMroz TERiew KD: Patient-reported outcome instruments in spine surgery. Spine (Phila Pa 1976) 41:4294372016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Khechen BHaws BEPatel DVBawa MSElboghdady IMLamoutte EH: PROMIS physical function score strongly correlates with legacy outcome measures in minimally invasive lumbar microdiscectomy. Spine (Phila Pa 1976) 44:4424462019

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Lim CRHarris KDawson JBeard DJFitzpatrick RPrice AJ: Floor and ceiling effects in the OHS: an analysis of the NHS PROMs data set. BMJ Open 5:e0077652015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    McCormick JDWerner BCShimer AL: Patient-reported outcome measures in spine surgery. J Am Acad Orthop Surg 21:991072013

  • 15

    Mehra ABaker DDisney SPynsent PB: Oswestry Disability Index scoring made easy. Ann R Coll Surg Engl 90:4974992008

  • 16

    Papuga MOMesfin AMolinari RRubery PT: Correlation of PROMIS Physical Function and Pain CAT instruments with Oswestry Disability Index and Neck Disability Index in spine patients. Spine (Phila Pa 1976) 41:115311592016

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Purvis TEAndreou ENeuman BJRiley LH IIISkolasky RL: Concurrent validity and responsiveness of PROMIS health domains among patients presenting for anterior cervical spine surgery. Spine (Phila Pa 1976) 42:E1357E13652017

    • Search Google Scholar
    • Export Citation
  • 18

    Roitberg BZThaci BAuffinger BKaplan LShen JBrown FD: Comparison between patient and surgeon perception of degenerative spine disease outcomes—a prospective blinded database study. Acta Neurochir (Wien) 155:7577642013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Schwartz CEFinkelstein JA: Understanding inconsistencies in patient-reported outcomes after spine treatment: response shift phenomena. Spine J 9:103910452009

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Teles ARKhoshhal KIFalavigna A: Why and how should we measure outcomes in spine surgery? J Taibah Univ Med Sci 11:91972016

  • 21

    Tibbles ACWaalen JKHains FC: Response set bias, internal consistency and construct validity of the Oswestry Low Back Pain Disability Questionnaire. J Can Chiropr Assoc 42:1411491998

    • Search Google Scholar
    • Export Citation
  • 22

    Tonosu JTakeshita KHara NMatsudaira KKato SMasuda K: The normative score and the cut-off value of the Oswestry Disability Index (ODI). Eur Spine J 21:159616022012

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Vianin M: Psychometric properties and clinical usefulness of the Oswestry Disability Index. J Chiropr Med 7:1611632008

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