TY - JOUR
T1 - Validation of the recently developed Total Disability Index
T2 - A single measure of disability in neck and back pain patients
AU - Cruz, Dana L.
AU - Ayres, Ethan W.
AU - Spiegel, Matthew A.
AU - Day, Louis M.
AU - Hart, Robert A.
AU - Ames, Christopher P.
AU - Burton, Douglas C.
AU - Smith, Justin S.
AU - Shaffrey, Christopher I.
AU - Schwab, Frank J.
AU - Errico, Thomas J.
AU - Bess, Shay
AU - Lafage, Virginie
AU - Protopsaltis, Themistocles S.
N1 - Publisher Copyright:
© AANS 2020.
PY - 2020
Y1 - 2020
N2 - OBJECTIVE Neck and back pain are highly prevalent conditions that account for major disability. The Neck Disability Index (NDI) and Oswestry Disability Index (ODI) are the two most common functional status measures for neck and back pain. However, no single instrument exists to evaluate patients with concurrent neck and back pain. The recently developed Total Disability Index (TDI) combines overlapping elements from the ODI and NDI with the unique items from each. This study aimed to prospectively validate the TDI in patients with spinal deformity, back pain, and/or neck pain. METHODS This study is a retrospective review of prospectively collected data from a single center. The 14-item TDI, derived from ODI and NDI domains, was administered to consecutive patients presenting to a spine practice. Patients were assessed using the ODI, NDI, and EQ-5D. Validation of internal consistency, test-retest reproducibility, and validity of reconstructed NDI and ODI scores derived from TDI were assessed. RESULTS A total of 252 patients (mean age 55 years, 56% female) completed initial assessments (back pain, n = 115; neck pain, n = 52; back and neck pain, n = 55; spinal deformity, n = 55; and no pain/deformity, n = 29). Of these patients, 155 completed retests within 14 days. Patients represented a wide range of disability (mean ODI score: 36.3 ± 21.6; NDI score: 30.8 ± 21.8; and TDI score: 34.1 ± 20.0). TDI demonstrated excellent internal consistency (Cronbach's alpha = 0.922) and test-retest reliability (intraclass correlation coefficient = 0.96). Differences between actual and reconstructed scores were not clinically significant. Subanalyses demonstrated TDI's ability to quantify the degree of disability due to back or neck pain in patients complaining of pain in both regions. CONCLUSIONS The TDI is a valid and reliable disability measure in patients with back and/or neck pain and can capture each spine region's contribution to total disability. The TDI could be a valuable method for total spine assessment in a clinical setting, and its completion is less time consuming than that for both the ODI and NDI.
AB - OBJECTIVE Neck and back pain are highly prevalent conditions that account for major disability. The Neck Disability Index (NDI) and Oswestry Disability Index (ODI) are the two most common functional status measures for neck and back pain. However, no single instrument exists to evaluate patients with concurrent neck and back pain. The recently developed Total Disability Index (TDI) combines overlapping elements from the ODI and NDI with the unique items from each. This study aimed to prospectively validate the TDI in patients with spinal deformity, back pain, and/or neck pain. METHODS This study is a retrospective review of prospectively collected data from a single center. The 14-item TDI, derived from ODI and NDI domains, was administered to consecutive patients presenting to a spine practice. Patients were assessed using the ODI, NDI, and EQ-5D. Validation of internal consistency, test-retest reproducibility, and validity of reconstructed NDI and ODI scores derived from TDI were assessed. RESULTS A total of 252 patients (mean age 55 years, 56% female) completed initial assessments (back pain, n = 115; neck pain, n = 52; back and neck pain, n = 55; spinal deformity, n = 55; and no pain/deformity, n = 29). Of these patients, 155 completed retests within 14 days. Patients represented a wide range of disability (mean ODI score: 36.3 ± 21.6; NDI score: 30.8 ± 21.8; and TDI score: 34.1 ± 20.0). TDI demonstrated excellent internal consistency (Cronbach's alpha = 0.922) and test-retest reliability (intraclass correlation coefficient = 0.96). Differences between actual and reconstructed scores were not clinically significant. Subanalyses demonstrated TDI's ability to quantify the degree of disability due to back or neck pain in patients complaining of pain in both regions. CONCLUSIONS The TDI is a valid and reliable disability measure in patients with back and/or neck pain and can capture each spine region's contribution to total disability. The TDI could be a valuable method for total spine assessment in a clinical setting, and its completion is less time consuming than that for both the ODI and NDI.
KW - Back pain
KW - Health-related quality of life
KW - Lumbar
KW - Neck pain
KW - Total Disability Index
UR - http://www.scopus.com/inward/record.url?scp=85082800556&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85082800556&partnerID=8YFLogxK
U2 - 10.3171/2019.9.SPINE19331
DO - 10.3171/2019.9.SPINE19331
M3 - Article
C2 - 31812146
AN - SCOPUS:85082800556
SN - 1547-5654
VL - 32
SP - 533
EP - 541
JO - Journal of Neurosurgery: Spine
JF - Journal of Neurosurgery: Spine
IS - 4
ER -