TY - JOUR
T1 - Developing the total disability index based on an analysis of the interrelationships and limitations of oswestry and neck disability index
AU - Spiegel, Matthew A.
AU - Lafage, Renaud
AU - Lafage, Virginie
AU - Ryan, Devon
AU - Marascalchi, Bryan
AU - Trimba, Yuriy
AU - Ames, Christopher
AU - Harris, Bradley
AU - Tanzi, Elizabeth
AU - Oren, Jonathan
AU - Vira, Shaleen
AU - Errico, Thomas
AU - Schwab, Frank
AU - Protopsaltis, Themistocles S.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Study Design. Retrospective. Objective. This study assessed the feasibility of combining Oswestry and Neck Disability Index (ODI and NDI) into 1 shorter Total Disability Index (TDI) from which reconstructed scores could be computed. Summary of Background Data. ODI and NDI are not pure assessments of disability related to back and neck, respectively. Because of similarities/redundancies of questions, ODI scores may be elevated in neck-pain patients and the converse is true for NDI in back-pain patients. Methods. Spine patients completed ODI and NDI, and complaints were recorded as back pain (BP), neck pain (NP), or both (BNP). Questionnaire scores were compared across cohorts via descriptives and Spearman (r) correlations. In exploring the feasibility of merging ODI/NDI, TDI was constructed from 9 ODI and 5 NDI items. Extracting questions from TDI, reconstructed 9-item rODI and 10-item rNDI indices were formed and compared with true ODI/NDI. Results. There were a total of 1207 patients: 741 BP, 134 NP, and 268 BNP. Mean ODI was 37±21 and mean NDI was 32±21. Patients with concurrent BP and NP had significantly more disability. Seventy-eight patients of 134 (58%) patients with NP only had at least moderate disability by ODI and 297 of 741 (40%) patients with back pain only, had at least moderate disability by NDI. ODI versus NDI correlation was r =0.755; ODI versus reconstructed rODI correlated at r=0.985, and NDI versus reconstructed rNDI correlated at r=0.967 (P<0.01). Conclusion. Elevated ODI/NDI scores in patients with isolated complaints show that disability in 1 region affects scores on both surveys. This study constructed a 14-item TDI that represents every domain of ODI/NDI with exception of ODI Sex Life. From this TDI, reconstructed scores correlated near perfectly with true scores. TDI provides a more global assessment of spinal disability and is a questionnaire that reduces the time burden to patients. The TDI allows for simultaneous assessment of back, neck, and global spinal disability.
AB - Study Design. Retrospective. Objective. This study assessed the feasibility of combining Oswestry and Neck Disability Index (ODI and NDI) into 1 shorter Total Disability Index (TDI) from which reconstructed scores could be computed. Summary of Background Data. ODI and NDI are not pure assessments of disability related to back and neck, respectively. Because of similarities/redundancies of questions, ODI scores may be elevated in neck-pain patients and the converse is true for NDI in back-pain patients. Methods. Spine patients completed ODI and NDI, and complaints were recorded as back pain (BP), neck pain (NP), or both (BNP). Questionnaire scores were compared across cohorts via descriptives and Spearman (r) correlations. In exploring the feasibility of merging ODI/NDI, TDI was constructed from 9 ODI and 5 NDI items. Extracting questions from TDI, reconstructed 9-item rODI and 10-item rNDI indices were formed and compared with true ODI/NDI. Results. There were a total of 1207 patients: 741 BP, 134 NP, and 268 BNP. Mean ODI was 37±21 and mean NDI was 32±21. Patients with concurrent BP and NP had significantly more disability. Seventy-eight patients of 134 (58%) patients with NP only had at least moderate disability by ODI and 297 of 741 (40%) patients with back pain only, had at least moderate disability by NDI. ODI versus NDI correlation was r =0.755; ODI versus reconstructed rODI correlated at r=0.985, and NDI versus reconstructed rNDI correlated at r=0.967 (P<0.01). Conclusion. Elevated ODI/NDI scores in patients with isolated complaints show that disability in 1 region affects scores on both surveys. This study constructed a 14-item TDI that represents every domain of ODI/NDI with exception of ODI Sex Life. From this TDI, reconstructed scores correlated near perfectly with true scores. TDI provides a more global assessment of spinal disability and is a questionnaire that reduces the time burden to patients. The TDI allows for simultaneous assessment of back, neck, and global spinal disability.
KW - Back pain
KW - Cervical deformity
KW - Health-related quality of life
KW - Neck Disability Index
KW - Neck pain
KW - Oswestry Disability Index
KW - Thoracolumbar deformity
KW - Total Disability Index
UR - http://www.scopus.com/inward/record.url?scp=84952891179&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84952891179&partnerID=8YFLogxK
U2 - 10.1097/BRS.0000000000001159
DO - 10.1097/BRS.0000000000001159
M3 - Article
C2 - 26335678
AN - SCOPUS:84952891179
SN - 0362-2436
VL - 41
SP - 74
EP - 81
JO - Spine
JF - Spine
IS - 1
ER -