Duke University Division of Physical Therapy, Duke Department of Orthopaedic Surgery, Duke Clinical Research Institute, Durham, NC.
Department of Public Health and Community Medicine, School of Medicine, Tufts University.
Spine (Phila Pa 1976). 2021 Jan 15;46(2):E118-E125. doi: 10.1097/BRS.0000000000003732.
This is an observational study on the measurement properties of the Oswestry Disability Index (ODI) version 1.0.
To (1) determine the construct validity of the tool, specifically structural validity; (2) analyze the criterion validity of the tool, specifically concurrent validity against proxy measures of pain, function, and quality of life and predictive validity of each item to proxy measures of disability; and (3) reliability of the tool, specifically internal consistency.
We endeavored to investigate the measurement properties of the ODI on a spine surgery population to test the assumption that a more disabled population may influence the properties of the tool.
Data were pulled from the Quality Outcomes Database (QOD) Spine Registry. A total of 57,199 participants who underwent primary or revision lumbar spine surgeries were included. Structural validity was assessed by exploratory and confirmatory factor analysis, concurrent validity, predictive validity by odds ratios, and internal consistency by Cronbach alpha. The Visual Analog Scale for back pain, two standard open questions, and the EuroQol 5 Dimension/Visual Analogue Scale were included as proxy measures of pain, function, and quality of life, respectively. Hospital readmission, return to operating room for treatment and revision surgery (all within 30 days) were included as proxy measures of disability to assess the predictive validity of each ODI item.
The ODI demonstrated a two-factor structural solution, which explained 54.9% of the total variance. Fair internal consistency (0.74-0.77), and fair criterion validity (concurrent) and significant findings with predictive validity (P < 0.01) substantiated the use of each item of the ODI as well as the summary score and ODI thresholds.
Our study lends value to a burgeoning repository of evidence that suggests the ODI is a useful tool for capturing outcomes in clinical practice. We recommend its continued use in clinical practice.Level of Evidence: 4.
这是一项观察性研究，旨在评估 Oswestry 残疾指数（ODI）版本 1.0 的测量特性。
（1）确定该工具的结构有效性，特别是结构有效性；（2）分析该工具的标准有效性，特别是与疼痛、功能和生活质量的代理测量值的同时有效性和每个项目对残疾代理测量值的预测有效性；（3）该工具的可靠性，特别是内部一致性。
我们努力调查脊柱手术人群中 ODI 的测量特性，以检验假设，即更残疾的人群可能会影响工具的特性。
从质量结果数据库（QOD）脊柱登记处提取数据。共纳入 57199 例接受原发性或翻修腰椎手术的患者。结构有效性通过探索性和验证性因子分析进行评估，同时有效性通过优势比进行评估，预测有效性通过 Cronbach alpha 进行评估。视觉模拟量表用于背痛、两个标准开放问题和欧洲五维健康量表视觉模拟量表分别作为疼痛、功能和生活质量的代理测量值。住院再入院、因治疗和翻修手术返回手术室（均在 30 天内）作为残疾的代理测量值，用于评估每个 ODI 项目的预测有效性。
ODI 表现出双因素结构解决方案，解释了总方差的 54.9%。内部一致性较好（0.74-0.77），同时具有良好的标准有效性（同时）和显著的预测有效性（P<0.01），这证实了 ODI 的每个项目以及总分和 ODI 阈值的使用。
我们的研究为日益增多的证据提供了价值，这些证据表明 ODI 是一种在临床实践中捕获结果的有用工具。我们建议在临床实践中继续使用它。
4 级。
