The Maine-Seattle back questionnaire: A 12-item disability questionnaire for evaluating patients with lumbar sciatica or stenosis: Results of a derivation and validation cohort analysis

Steven J. Atlas, Richard A. Deyo, Melissa Van den Ancker, Daniel E. Singer, Robert B. Keller, Donald L. Patrick

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

Study Design. Analysis of health-related quality of life data obtained from a prospective cohort study of patients with sciatica due to an intervertebral disc herniation or lumbar spinal stenosis. Objective. To derive and validate a shortened version of a previously validated 23-item modification of the Roland-Morris Disability Questionnaire. Summary of Background Data. For patients with low back pain, improving health-related quality of life is often the main goal of therapy. The Roland-Morris Disability Questionnaire is one of the best validated and most frequently used back-specific functional status measures. A shortened version may permit more widespread use in clinical and research settings. Methods. Data from 507 patients with sciatica enrolled in the Maine Lumbar Spine Study were used to derive a shortened version of a 23-item modification of the original Roland-Morris Disability Questionnaire using qualitative and cluster analysis techniques. The internal consistency, construct validity, reproducibility, and responsiveness in detecting change over a 3-month period for a new 12-item scale was compared to the original 23-item scale. The 12-item scale was then validated in an independent cohort of 148 patients with lumbar spinal stenosis. Results. Internal consistency was very good but modestly lower for the 12-item instrument compared to the 23-item original scale. Reproducibility over a 3-month interval was good and did not differ between the 12-item and original scale. Findings from the validation cohort were similar or better than the derivation cohort. A high degree of construct validity with patient-reported symptoms was demonstrated for the 12-item and original scales. The responsiveness and interpretability of the 12-item scale over 3 months was excellent and comparable to the original scale. Responsiveness assessed in patients with lumbar spinal stenosis in the independent validation cohort showed consistent findings compared to patients with a disc herniation in the derivation cohort. Conclusions. This short, simple, self-administered 12-item back-specific functional status questionnaire performed extremely well in comparison with the original 23-item scale. If validated in additional study populations, this new questionnaire may be useful in the clinical setting as a way for providers to prospectively compare their outcomes of care to other patient populations, and to study treatment effectiveness.

Original languageEnglish (US)
Pages (from-to)1869-1876
Number of pages8
JournalSpine
Volume28
Issue number16
DOIs
StatePublished - Aug 15 2003

Keywords

  • Health-related quality of life
  • Lumbar intervertebral disc herniation
  • Lumbar spinal stenosis
  • Outcome measures
  • Prospective cohort study
  • Sciatica

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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