Joelson Anders, Fritzell Peter, Hägg Olle
Department of Orthopedics, Orebro University School of Medical Sciences and Orebro University Hospital, Orebro, Sweden.
The National Swedish Spine Register (Swespine), Jonkoping, Sweden.
Eur Spine J. 2022 Dec;31(12):3484-3491. doi: 10.1007/s00586-022-07425-2. Epub 2022 Oct 22.
The Oswestry Disability Index (ODI) and the Neck Disability Index (NDI) scoring algorithms used by the Swedish spine register (Swespine) until April 2022 handled missing items somewhat differently than the original algorithms. The purpose of the current study was to evaluate possible differences in the ODI and NDI scores between the Swespine and the original scoring algorithms.
Patients surgically treated for degenerative conditions of the lumbar or cervical spine between 2003-2019 (lumbar) and 2006-2019 (cervical) were identified in Swespine. Preoperative and 1-year postoperative ODI/NDI data were used to evaluate differences between the Swespine and the original ODI/NDI algorithms with adjustment for at most 1 or 2 missing items using mean imputation.
The preoperative as well as the 1-year postoperative ODI/NDI were approximately 1 unit out of 100 smaller for the Swespine algorithm, irrespective of adjustment model. The differences between preoperative and postoperative ODI/NDI scores were similar between the Swespine and the original scoring algorithms. There were occasional statistically significant differences between the preoperative-postoperative differences due to large sample sizes.
The Swespine algorithms, used until April 2022, underestimated the ODI and NDI by approximately 1 out of 100 units compared with the original algorithms. In addition, there were no statistically significant differences between the original algorithms when adjusting for at most 1 or 2 missing items. The algorithm has now been changed, also for historical data.
瑞典脊柱登记系统（Swespine）在2022年4月之前使用的奥斯威斯利残疾指数（ODI）和颈部残疾指数（NDI）评分算法在处理缺失项目方面与原始算法略有不同。本研究的目的是评估Swespine与原始评分算法在ODI和NDI评分上的可能差异。
在Swespine中识别出2003 - 2019年（腰椎）和2006 - 2019年（颈椎）因腰椎或颈椎退行性疾病接受手术治疗的患者。术前和术后1年的ODI/NDI数据用于评估Swespine与原始ODI/NDI算法之间的差异，并使用均值插补法对最多1或2个缺失项目进行调整。
无论调整模型如何，Swespine算法的术前以及术后1年的ODI/NDI比原始算法约低1个百分点（满分100分）。Swespine与原始评分算法之间术前和术后ODI/NDI评分的差异相似。由于样本量较大，术前与术后差异偶尔存在统计学显著差异。
与原始算法相比，直到2022年4月使用的Swespine算法将ODI和NDI低估了约1个百分点（满分100分）。此外，在对最多1或2个缺失项目进行调整时，原始算法之间没有统计学显著差异。该算法现已更改，历史数据也同样适用。
