Vishwanathan Karthik, Braithwaite Ian
Charutar Arogya Mandal, Shri Krishna Hospital, Pramukhswami Medical College, Karamsad, India.
Nuffield Hospital, Chester, UK.
Asian Spine J. 2019 Jun 3;13(5):753-762. doi: 10.31616/asj.2018.0334. Print 2019 Oct.
Prospective observational cohort study.
To evaluate the comparative responsiveness of Oswestry Disability Index (ODI, version 2.0), 24-item Roland-Morris Disability Questionnaire (RMDQ), 12-item Short-Form Health Survey (SF-12) physical component score (PCS), and SF-12 mental component score (MCS) in patients that underwent micro-discectomy for lumbar disc herniation.
Responsiveness is a context specific term and no study has reported the responsiveness of ODI version 2.0, RMDQ, SF-12 PCS, or SF-12 MCS in discectomy patients.
Responsiveness was assessed using distribution-based methods (effect size [ES], standardized response means [SRM ], SRM difference between patients who improved and those who did not show improvement [SRM difference]), and the anchor-based method (area under the curve [AUC] of receiver operating characteristic curves). Values of ES and SRM higher than 0.8, and AUC value higher than 0.7 suggest adequate responsiveness. Outcome instrument demonstrating the highest value of SRM difference and AUC was considered the most responsive.
Responsiveness was assessed in 98 participants at a mean follow-up time of 12 weeks postoperatively. The overall ES of RMDQ, ODI, SF-12 PCS, and SF-12 MCS was 2.15, 2.11, 2.08, and 0.86, respectively. The overall SRM of ODI, RMDQ, SF-12 PCS, and SF-12 MCS was 1.36, 1.43, 1.24, and 0.65, respectively. The SRM difference in RMDQ, ODI, SF-12 PCS, and SF-12 MCS was 2.64, 2.26, 1.32, and 1.29, respectively. The AUC of ODI, RMDQ, SF-12 PCS, and SF-12 MCS was 0.96, 0.96, 0.83, and 0.83, respectively.
ODI, RMDQ, SF-12 PCS, and SF-12 MCS demonstrated adequate responsiveness in a homogenous cohort of patients who underwent lumbar micro-discectomy. ODI and RMDQ are equally responsive and, thus, are interchangeable instruments for region specific outcomes. Both the SF-12 PCS and SF-12 MCS can assess the quality of life following lumbar micro-discectomy.
前瞻性观察队列研究。
评估接受腰椎间盘突出症显微椎间盘切除术患者的Oswestry功能障碍指数（ODI，第2.0版）、24项罗兰-莫里斯功能障碍问卷（RMDQ）、12项简短健康调查问卷（SF-12）身体成分得分（PCS）和SF-12心理成分得分（MCS）的相对反应性。
反应性是一个特定背景的术语，尚无研究报告ODI第2.0版、RMDQ、SF-12 PCS或SF-12 MCS在椎间盘切除术患者中的反应性。
使用基于分布的方法（效应大小[ES]、标准化反应均值[SRM]、改善患者与未改善患者之间的SRM差异[SRM差异]）和基于锚定的方法（受试者工作特征曲线的曲线下面积[AUC]）评估反应性。ES和SRM值高于0.8，以及AUC值高于0.7表明反应性良好。SRM差异和AUC值最高的结局工具被认为是反应性最强的。
对98名参与者进行了反应性评估，术后平均随访时间为12周。RMDQ、ODI、SF-12 PCS和SF-12 MCS的总体ES分别为2.15、2.11、2.08和0.86。ODI、RMDQ、SF-12 PCS和SF-12 MCS的总体SRM分别为1.36、1.43、1.24和0.65。RMDQ、ODI、SF-12 PCS和SF-12 MCS的SRM差异分别为2.64、2.26、1.32和1.29。ODI、RMDQ、SF-12 PCS和SF-12 MCS的AUC分别为0.96、0.96、0.83和0.83。
ODI、RMDQ、SF-12 PCS和SF-12 MCS在接受腰椎显微椎间盘切除术的同质患者队列中显示出良好的反应性。ODI和RMDQ的反应性相同，因此是用于特定区域结局的可互换工具。SF-12 PCS和SF-12 MCS均可评估腰椎显微椎间盘切除术后的生活质量。
