Department of Orthopedic Surgery, Japan Community Healthcare Organization, Osaka Hospital, 4-2-78 Fukushimaku, Fukushima, Osaka 553-0003, Japan; Department of Orthopedic Surgery, Sumitomo Hospital, 5-3-20 Kitaku Nakanoshima, Osaka, Osaka 530-0005, Japan.
Department of Orthopedic Surgery, Sumitomo Hospital, 5-3-20 Kitaku Nakanoshima, Osaka, Osaka 530-0005, Japan.
Spine J. 2019 Jan;19(1):95-103. doi: 10.1016/j.spinee.2018.05.013. Epub 2018 May 21.
Introduced in 2007, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) has been widely used, but its psychometric properties have not been well studied.
The objective of this study was to assess the responsiveness of the JOABPEQ in lumbar surgery and its threshold for indicating clinically important differences.
This is a prospective study.
Two hundred three consecutive patients underwent lumbar surgeries between July 2013 and November 2015 in a single hospital. Of the 203 patients, 181 patients who completed 1 year of follow-up were included.
Before and after surgery, the patients were asked to complete the questionnaire, including JOABPEQ, the 8-Item Short Form Health Survey (SF-8), and EuroQol-5D (EQ-5D). The participants were divided into five anchoring groups, ranging from "much better" to "much worse," according to reports from both physicians and patients.
The responsiveness of measures was compared among five domains of the JOABPEQ ("low back pain," "walking ability," "lumbar function," "social function," and "mental health"), two domains of the SF-8 (the physical component summary [PCS] and the mental component summary [MCS]), and the EQ-5D. The responsiveness was assessed by the paired t test, the effect size, and the standardized response mean. The Spearman rank correlation coefficient and the receiver operating characteristic (ROC) curve were assessed using the five anchoring groups as external criteria. The clinically important differences, based on the ROC curve, were assessed.
Walking ability was most responsive, followed by low back pain and the PCS. The MCS was least responsive, followed by mental health and lumbar function. Social function and the EQ-5D had intermediate-level responsiveness. The substantial clinically important differences occurred at 20 points for low back pain and lumbar function, 23 points for walking ability, 14 points for social function, and 8 points for mental health.
The JOABPEQ domains are responsive measures in patients who undergo lumbar surgery. For physical function, the threshold for substantial clinically important differences was approximately 20 points for the JOABPEQ.
日本矫形协会腰痛评估问卷（JOABPEQ）于 2007 年推出，应用广泛，但尚未对其信度和效度进行很好的研究。
本研究旨在评估 JOABPEQ 在腰椎手术中的反应能力及其表示临床重要差异的阈值。
前瞻性研究。
2013 年 7 月至 2015 年 11 月，一家医院的 203 例连续患者接受了腰椎手术。203 例患者中，181 例完成 1 年随访的患者纳入本研究。
手术前后，患者均完成问卷，包括 JOABPEQ、8 项简明健康调查量表（SF-8）和 EuroQol-5D（EQ-5D）。根据医生和患者的报告，将参与者分为五个锚定组，范围从“好得多”到“差得多”。
比较 JOABPEQ 的五个领域（“腰痛”、“行走能力”、“腰椎功能”、“社会功能”和“心理健康”）、SF-8 的两个领域（生理成分综合评分[PCS]和心理成分综合评分[MCS]）和 EQ-5D 的反应能力。采用配对 t 检验、效应量和标准化反应均值评估指标的反应能力。采用 Spearman 秩相关系数和接收者操作特征（ROC）曲线评估五个锚定组作为外部标准的反应能力。基于 ROC 曲线，评估临床重要差异。
行走能力最敏感，其次是腰痛和 PCS。MCS 最不敏感，其次是心理健康和腰椎功能。社会功能和 EQ-5D 具有中等反应能力。腰痛和腰椎功能的临床重要差异为 20 分，行走能力为 23 分，社会功能为 14 分，心理健康为 8 分。
JOABPEQ 各领域是腰椎手术后患者的敏感指标。对于生理功能，JOABPEQ 的临床重要差异阈值约为 20 分。
