Department of Orthopaedic Surgery, University of California, San Diego, San Diego, CA.
Department of Neurosurgery, University of Virginia, Charlottesville, VA.
Spine (Phila Pa 1976). 2024 May 15;49(10):682-688. doi: 10.1097/BRS.0000000000004960. Epub 2024 Feb 15.
Retrospective cohort.
To examine the validity of the Oswestry Disability Index (ODI) in patients with adult spinal deformity (ASD) treated with surgery.
The ODI is a patient-reported outcome measure of low back pain and disability. Although nearly ubiquitous in ASD research, the measure has not been validated in this patient population.
A registry of patients with ASD was queried for baseline and 1-year PROM data, including the ODI, the Scoliosis Research Society-22r (SRS-22r), and the Patient Reported Outcomes Measurement Information System-Pain Interference (PI) and Physical Function (PF) CATs. Internal reliability was assessed with Cronbach alpha, where values ≥0.7 are considered reliable. Validity was assessed with Spearman correlation coefficients calculated for the ODI against validated Patient-Reported Outcomes Measurement Information System (PROMIS)-PI and PF, and legacy measures SRS-Pain and SRS-Activity. Responsiveness to change was measured with the adjusted effect size.
A total of 325 patients were enrolled, with 208 completing baseline and 1-year patient-reported outcome measures. The majority (149, 72%) were females and White (193, 93%), median Charlson Comorbidity Index 0 (interquartile range: 0-2). The majority of cases included sagittal plane deformity [mean T1PA: 24.2° (13.9)]. Cronbach alpha showed excellent internal reliability (baseline = 0.89, 1 yr = 0.90). ODI was valid, with strong correlations between PROMIS-PI, PROMIS-PF, SRS-Pain, and SRS-Activity at baseline and 1-year follow-up. All measures were responsive to change, with the ODI showing greater responsiveness than PROMIS-PI, PROMIS-PF, and SRS-Activity.
The ODI is a valid measure of disability as measured by pain and function in patients with ASD. It is responsive to change in a manner not different from validated PROMIS-CAT or the SRS-22r legacy measure. It is multidimensional, however, as it assesses both pain and function simultaneously. It does not measure disability related to self-image and may not account for all disease-related disability in patients with ASD.
回顾性队列研究。
研究 Oswestry 功能障碍指数（ODI）在接受手术治疗的成人脊柱畸形（ASD）患者中的有效性。
ODI 是一种用于评估腰痛和残疾的患者报告结局测量工具。尽管在 ASD 研究中几乎无处不在，但该测量工具尚未在该患者人群中得到验证。
查询 ASD 患者的登记处，以获取基线和 1 年 PROM 数据，包括 ODI、脊柱侧凸研究协会 22r（SRS-22r）以及患者报告的结果测量信息系统-疼痛干扰（PI）和身体功能（PF）CAT。使用 Cronbach alpha 评估内部可靠性，其中≥0.7 的值被认为是可靠的。通过计算 ODI 与经过验证的患者报告的结果测量信息系统（PROMIS）-PI 和 PF 以及传统的 SRS-疼痛和 SRS-活动的 Spearman 相关系数来评估有效性。通过调整后的效应量来衡量对变化的反应能力。
共纳入 325 例患者，其中 208 例完成了基线和 1 年的患者报告结局测量。大多数患者（149 例，72%）为女性，193 例（93%）为白人，中位 Charlson 合并症指数为 0（四分位距：0-2）。大多数病例包括矢状面畸形[平均 T1PA：24.2°（13.9）]。Cronbach alpha 显示出极好的内部可靠性（基线=0.89，1 年=0.90）。ODI 是有效的，在基线和 1 年随访时，与 PROMIS-PI、PROMIS-PF、SRS-疼痛和 SRS-活动均具有较强的相关性。所有措施均能反应变化，ODI 的反应能力大于 PROMIS-PI、PROMIS-PF 和 SRS-活动。
ODI 是一种有效的 ASD 患者疼痛和功能相关残疾的测量工具。它对变化的反应与经过验证的 PROMIS-CAT 或 SRS-22r 传统测量工具相似。然而，它是多维的，因为它同时评估疼痛和功能。它不测量与自我形象相关的残疾，也可能无法涵盖 ASD 患者所有与疾病相关的残疾。
