Diagnostic Screening for Lumbar Spinal Stenosis
Purpose: To develop a self-administered diagnostic screening questionnaire for lumbar spinal stenosis (LSS) consisting of items with high content validity and to investigate the diagnostic value of the questionnaire and the items. Patients and Methods: A self-reported diagnostic LSS screening questi...
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| Veröffentlicht in: | Clinical epidemiology 2020-01, Vol.12, p.891-905 |
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| creator | Jensen, Rikke Kruger Lauridsen, Henrik Hein Andresen, Andreas Duch Kiilerich Mieritz, Rune Mygind Schiottz-Christensen, Berit Vach, Werner |
| description | Purpose: To develop a self-administered diagnostic screening questionnaire for lumbar spinal stenosis (LSS) consisting of items with high content validity and to investigate the diagnostic value of the questionnaire and the items.
Patients and Methods: A self-reported diagnostic LSS screening questionnaire was developed based on items from the existing literature describing key symptoms of LSS. The screening questionnaire (index test) was to be tested in a cohort of patients with persistent lumbar and/or leg pain recruited from a Danish publicly funded outpatient secondary care spine clinic with clinicians performing the reference test. However, to avoid unnecessary collection of data if the screening questionnaire proved to be of limited value, a case-control design was incorporated into the cohort design including an interim analysis. Additional cases for the case-control study were recruited at two Danish publicly funded spine surgery departments. Prevalence, sensitivity, specificity and diagnostic odds ratio (OR) were calculated for each individual item, and AUC (area under the curve) was calculated to examine the performance of the full questionnaire.
Results: A 13-item Danish questionnaire was developed and tested in 153 cases and 230 controls. The interim analysis was not in favour of continuing the cohort study, and therefore, only results from the case-control study are reported. There was a positive association for all items except the presence of back pain. However, the association was only moderate with ORs up to 3.3. When testing the performance of the whole questionnaire, an AUC of 0.72 was reached with a specificity of 20% for a fixed sensitivity of 95%.
Conclusion: The items were associated with LSS and therefore have some potential to identify LSS patients. However, the association was not strong enough to provide sufficient accuracy for a diagnostic tool. Additional dimensions of symptoms of LSS need identification to obtain a reliable questionnaire for screening purposes. |
| doi_str_mv | 10.2147/CLEP.S263646 |
| format | Article |
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Patients and Methods: A self-reported diagnostic LSS screening questionnaire was developed based on items from the existing literature describing key symptoms of LSS. The screening questionnaire (index test) was to be tested in a cohort of patients with persistent lumbar and/or leg pain recruited from a Danish publicly funded outpatient secondary care spine clinic with clinicians performing the reference test. However, to avoid unnecessary collection of data if the screening questionnaire proved to be of limited value, a case-control design was incorporated into the cohort design including an interim analysis. Additional cases for the case-control study were recruited at two Danish publicly funded spine surgery departments. Prevalence, sensitivity, specificity and diagnostic odds ratio (OR) were calculated for each individual item, and AUC (area under the curve) was calculated to examine the performance of the full questionnaire.
Results: A 13-item Danish questionnaire was developed and tested in 153 cases and 230 controls. The interim analysis was not in favour of continuing the cohort study, and therefore, only results from the case-control study are reported. There was a positive association for all items except the presence of back pain. However, the association was only moderate with ORs up to 3.3. When testing the performance of the whole questionnaire, an AUC of 0.72 was reached with a specificity of 20% for a fixed sensitivity of 95%.
Conclusion: The items were associated with LSS and therefore have some potential to identify LSS patients. However, the association was not strong enough to provide sufficient accuracy for a diagnostic tool. Additional dimensions of symptoms of LSS need identification to obtain a reliable questionnaire for screening purposes.</description><identifier>ISSN: 1179-1349</identifier><identifier>EISSN: 1179-1349</identifier><identifier>DOI: 10.2147/CLEP.S263646</identifier><identifier>PMID: 32904080</identifier><language>eng</language><publisher>ALBANY: Dove Medical Press Ltd</publisher><subject>Age ; Back pain ; Clinical medicine ; Data collection ; Diagnosis ; diagnostic screening ; Epidemiology ; Interviews ; Life Sciences & Biomedicine ; lumbar spinal stenosis ; Magnetic resonance imaging ; neurogenic claudication ; Original Research ; Patients ; Primary care ; Public, Environmental & Occupational Health ; questionnaire ; Questionnaires ; Science & Technology ; Spinal stenosis</subject><ispartof>Clinical epidemiology, 2020-01, Vol.12, p.891-905</ispartof><rights>2020 Jensen et al.</rights><rights>COPYRIGHT 2020 Dove Medical Press Limited</rights><rights>2020. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Jensen et al. 2020 Jensen et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>14</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000563060200001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c576t-60f7ffbee1799090c845cfd209b73e3b0b05d123279b1898c1d09e23654f5a763</citedby><cites>FETCH-LOGICAL-c576t-60f7ffbee1799090c845cfd209b73e3b0b05d123279b1898c1d09e23654f5a763</cites><orcidid>0000-0001-5198-5215 ; 0000-0003-3866-856X ; 0000-0001-7528-3234 ; 0000-0003-1865-8399 ; 0000-0003-0099-0836 ; 0000-0002-1757-3302</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7450213/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7450213/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2106,2118,3866,27933,27934,28257,53800,53802</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32904080$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jensen, Rikke Kruger</creatorcontrib><creatorcontrib>Lauridsen, Henrik Hein</creatorcontrib><creatorcontrib>Andresen, Andreas Duch Kiilerich</creatorcontrib><creatorcontrib>Mieritz, Rune Mygind</creatorcontrib><creatorcontrib>Schiottz-Christensen, Berit</creatorcontrib><creatorcontrib>Vach, Werner</creatorcontrib><title>Diagnostic Screening for Lumbar Spinal Stenosis</title><title>Clinical epidemiology</title><addtitle>CLIN EPIDEMIOL</addtitle><addtitle>Clin Epidemiol</addtitle><description>Purpose: To develop a self-administered diagnostic screening questionnaire for lumbar spinal stenosis (LSS) consisting of items with high content validity and to investigate the diagnostic value of the questionnaire and the items.
Patients and Methods: A self-reported diagnostic LSS screening questionnaire was developed based on items from the existing literature describing key symptoms of LSS. The screening questionnaire (index test) was to be tested in a cohort of patients with persistent lumbar and/or leg pain recruited from a Danish publicly funded outpatient secondary care spine clinic with clinicians performing the reference test. However, to avoid unnecessary collection of data if the screening questionnaire proved to be of limited value, a case-control design was incorporated into the cohort design including an interim analysis. Additional cases for the case-control study were recruited at two Danish publicly funded spine surgery departments. Prevalence, sensitivity, specificity and diagnostic odds ratio (OR) were calculated for each individual item, and AUC (area under the curve) was calculated to examine the performance of the full questionnaire.
Results: A 13-item Danish questionnaire was developed and tested in 153 cases and 230 controls. The interim analysis was not in favour of continuing the cohort study, and therefore, only results from the case-control study are reported. There was a positive association for all items except the presence of back pain. However, the association was only moderate with ORs up to 3.3. When testing the performance of the whole questionnaire, an AUC of 0.72 was reached with a specificity of 20% for a fixed sensitivity of 95%.
Conclusion: The items were associated with LSS and therefore have some potential to identify LSS patients. However, the association was not strong enough to provide sufficient accuracy for a diagnostic tool. Additional dimensions of symptoms of LSS need identification to obtain a reliable questionnaire for screening purposes.</description><subject>Age</subject><subject>Back pain</subject><subject>Clinical medicine</subject><subject>Data collection</subject><subject>Diagnosis</subject><subject>diagnostic screening</subject><subject>Epidemiology</subject><subject>Interviews</subject><subject>Life Sciences & Biomedicine</subject><subject>lumbar spinal stenosis</subject><subject>Magnetic resonance imaging</subject><subject>neurogenic claudication</subject><subject>Original Research</subject><subject>Patients</subject><subject>Primary care</subject><subject>Public, Environmental & Occupational Health</subject><subject>questionnaire</subject><subject>Questionnaires</subject><subject>Science & Technology</subject><subject>Spinal stenosis</subject><issn>1179-1349</issn><issn>1179-1349</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>DOA</sourceid><recordid>eNqNkt-LEzEQxxdRvOO8N5-lIIig7U1-bLL7cnDUUw8KCtXnkM1O2pRtcia7iv-92Wutrfhg8pCQfOY7k8m3KJ4TmFHC5dV8cft5tqSCCS4eFeeEyHpKGK8fH-3PisuUNpAHY0RKeFqcMVoDhwrOi6t3Tq98SL0zk6WJiN751cSGOFkM20bHyfLeed1Nlj1myqVnxROru4SX-_Wi-Pr-9sv843Tx6cPd_GYxNaUU_VSAldY2iLmIGmowFS-NbSnUjWTIGmigbAllVNYNqerKkBZqpEyU3JZaCnZR3O1026A36j66rY4_VdBOPRyEuFI65qI7VBRFy2RDWpazWE6qShgNspS8BK2BZ63rndb90GyxNej7qLsT0dMb79ZqFb6rUYESlgVe7wVi-DZg6tXWJYNdpz2GISnKORFQMlll9OVf6CYMMXfwgWKSMibkH2ql8wOctyHnNaOousl_CdX4eZma_YPKs8WtM8Gjdfn8JODVUcAaddevU-iG3gWfTsG3O9DEkFJEe2gGATUaS43GUntjZfzFcQMP8G8bZaDaAT-wCTYZh97gAcvOKwUDAXQ0IZm7Xo8VzcPg-xz65v9D2S9mk-Pd</recordid><startdate>20200101</startdate><enddate>20200101</enddate><creator>Jensen, Rikke Kruger</creator><creator>Lauridsen, Henrik Hein</creator><creator>Andresen, Andreas Duch Kiilerich</creator><creator>Mieritz, Rune Mygind</creator><creator>Schiottz-Christensen, Berit</creator><creator>Vach, Werner</creator><general>Dove Medical Press Ltd</general><general>Dove Medical Press Limited</general><general>Taylor & Francis Ltd</general><general>Dove</general><general>Dove Medical Press</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7XB</scope><scope>8C1</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-5198-5215</orcidid><orcidid>https://orcid.org/0000-0003-3866-856X</orcidid><orcidid>https://orcid.org/0000-0001-7528-3234</orcidid><orcidid>https://orcid.org/0000-0003-1865-8399</orcidid><orcidid>https://orcid.org/0000-0003-0099-0836</orcidid><orcidid>https://orcid.org/0000-0002-1757-3302</orcidid></search><sort><creationdate>20200101</creationdate><title>Diagnostic Screening for Lumbar Spinal Stenosis</title><author>Jensen, Rikke Kruger ; Lauridsen, Henrik Hein ; Andresen, Andreas Duch Kiilerich ; Mieritz, Rune Mygind ; Schiottz-Christensen, Berit ; Vach, Werner</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c576t-60f7ffbee1799090c845cfd209b73e3b0b05d123279b1898c1d09e23654f5a763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Back pain</topic><topic>Clinical medicine</topic><topic>Data collection</topic><topic>Diagnosis</topic><topic>diagnostic screening</topic><topic>Epidemiology</topic><topic>Interviews</topic><topic>Life Sciences & Biomedicine</topic><topic>lumbar spinal stenosis</topic><topic>Magnetic resonance imaging</topic><topic>neurogenic claudication</topic><topic>Original Research</topic><topic>Patients</topic><topic>Primary care</topic><topic>Public, Environmental & Occupational Health</topic><topic>questionnaire</topic><topic>Questionnaires</topic><topic>Science & Technology</topic><topic>Spinal stenosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jensen, Rikke Kruger</creatorcontrib><creatorcontrib>Lauridsen, Henrik Hein</creatorcontrib><creatorcontrib>Andresen, Andreas Duch Kiilerich</creatorcontrib><creatorcontrib>Mieritz, Rune Mygind</creatorcontrib><creatorcontrib>Schiottz-Christensen, Berit</creatorcontrib><creatorcontrib>Vach, Werner</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Public Health Database</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Clinical epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jensen, Rikke Kruger</au><au>Lauridsen, Henrik Hein</au><au>Andresen, Andreas Duch Kiilerich</au><au>Mieritz, Rune Mygind</au><au>Schiottz-Christensen, Berit</au><au>Vach, Werner</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic Screening for Lumbar Spinal Stenosis</atitle><jtitle>Clinical epidemiology</jtitle><stitle>CLIN EPIDEMIOL</stitle><addtitle>Clin Epidemiol</addtitle><date>2020-01-01</date><risdate>2020</risdate><volume>12</volume><spage>891</spage><epage>905</epage><pages>891-905</pages><issn>1179-1349</issn><eissn>1179-1349</eissn><abstract>Purpose: To develop a self-administered diagnostic screening questionnaire for lumbar spinal stenosis (LSS) consisting of items with high content validity and to investigate the diagnostic value of the questionnaire and the items.
Patients and Methods: A self-reported diagnostic LSS screening questionnaire was developed based on items from the existing literature describing key symptoms of LSS. The screening questionnaire (index test) was to be tested in a cohort of patients with persistent lumbar and/or leg pain recruited from a Danish publicly funded outpatient secondary care spine clinic with clinicians performing the reference test. However, to avoid unnecessary collection of data if the screening questionnaire proved to be of limited value, a case-control design was incorporated into the cohort design including an interim analysis. Additional cases for the case-control study were recruited at two Danish publicly funded spine surgery departments. Prevalence, sensitivity, specificity and diagnostic odds ratio (OR) were calculated for each individual item, and AUC (area under the curve) was calculated to examine the performance of the full questionnaire.
Results: A 13-item Danish questionnaire was developed and tested in 153 cases and 230 controls. The interim analysis was not in favour of continuing the cohort study, and therefore, only results from the case-control study are reported. There was a positive association for all items except the presence of back pain. However, the association was only moderate with ORs up to 3.3. When testing the performance of the whole questionnaire, an AUC of 0.72 was reached with a specificity of 20% for a fixed sensitivity of 95%.
Conclusion: The items were associated with LSS and therefore have some potential to identify LSS patients. However, the association was not strong enough to provide sufficient accuracy for a diagnostic tool. Additional dimensions of symptoms of LSS need identification to obtain a reliable questionnaire for screening purposes.</abstract><cop>ALBANY</cop><pub>Dove Medical Press Ltd</pub><pmid>32904080</pmid><doi>10.2147/CLEP.S263646</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0001-5198-5215</orcidid><orcidid>https://orcid.org/0000-0003-3866-856X</orcidid><orcidid>https://orcid.org/0000-0001-7528-3234</orcidid><orcidid>https://orcid.org/0000-0003-1865-8399</orcidid><orcidid>https://orcid.org/0000-0003-0099-0836</orcidid><orcidid>https://orcid.org/0000-0002-1757-3302</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age Back pain Clinical medicine Data collection Diagnosis diagnostic screening Epidemiology Interviews Life Sciences & Biomedicine lumbar spinal stenosis Magnetic resonance imaging neurogenic claudication Original Research Patients Primary care Public, Environmental & Occupational Health questionnaire Questionnaires Science & Technology Spinal stenosis |
| title | Diagnostic Screening for Lumbar Spinal Stenosis |
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