Developing the Total Disability Index Based on an Analysis of the Interrelationships and Limitations of Oswestry and Neck Disability Index

STUDY DESIGN.Retrospective. OBJECTIVE.This study assessed the feasibility of combining Oswestry and Neck Disability Index (ODI and NDI) into 1 shorter “Total Disability Index” (TDI) from which reconstructed scores could be computed. SUMMARY OF BACKGROUND DATA.ODI and NDI are not pure assessments of...

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Veröffentlicht in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2016-01, Vol.41 (1), p.74-81
Hauptverfasser: Spiegel, Matthew A, Lafage, Renaud, Lafage, Virginie, Ryan, Devon, Marascalchi, Bryan, Trimba, Yuriy, Ames, Christopher, Harris, Bradley, Tanzi, Elizabeth, Oren, Jonathan, Vira, Shaleen, Errico, Thomas, Schwab, Frank, Protopsaltis, Themistocles S
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container_issue 1
container_start_page 74
container_title Spine (Philadelphia, Pa. 1976)
container_volume 41
creator Spiegel, Matthew A
Lafage, Renaud
Lafage, Virginie
Ryan, Devon
Marascalchi, Bryan
Trimba, Yuriy
Ames, Christopher
Harris, Bradley
Tanzi, Elizabeth
Oren, Jonathan
Vira, Shaleen
Errico, Thomas
Schwab, Frank
Protopsaltis, Themistocles S
description STUDY DESIGN.Retrospective. OBJECTIVE.This study assessed the feasibility of combining Oswestry and Neck Disability Index (ODI and NDI) into 1 shorter “Total Disability Index” (TDI) from which reconstructed scores could be computed. SUMMARY OF BACKGROUND DATA.ODI and NDI are not pure assessments of disability related to back and neck, respectively. Because of similarities/redundancies of questions, ODI scores may be elevated in neck-pain patients and the converse is true for NDI in back-pain patients. METHODS.Spine patients completed ODI and NDI, and complaints were recorded as back pain (BP), neck pain (NP), or both (BNP). Questionnaire scores were compared across cohorts via descriptives and Spearman (ρ) correlations. In exploring the feasibility of merging ODI/NDI, TDI was constructed from 9 ODI and 5 NDI items. Extracting questions from TDI, reconstructed 9-item rODI and 10-item rNDI indices were formed and compared with true ODI/NDI. RESULTS.There were a total of 1207 patients741 BP, 134 NP, and 268 BNP. Mean ODI was 37 ± 21 and mean NDI was 32 ± 21. Patients with concurrent BP and NP had significantly more disability. Seventy-eight patients of 134 (58%) patients with NP only had at least “moderate disability” by ODI and 297 of 741 (40%) patients with back pain only, had at least “moderate disability” by NDI. ODI versus NDI correlation was ρ = 0.755; ODI versus reconstructed rODI correlated at ρ = 0.985, and NDI versus reconstructed rNDI correlated at ρ = 0.967 (P 
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OBJECTIVE.This study assessed the feasibility of combining Oswestry and Neck Disability Index (ODI and NDI) into 1 shorter “Total Disability Index” (TDI) from which reconstructed scores could be computed. SUMMARY OF BACKGROUND DATA.ODI and NDI are not pure assessments of disability related to back and neck, respectively. Because of similarities/redundancies of questions, ODI scores may be elevated in neck-pain patients and the converse is true for NDI in back-pain patients. METHODS.Spine patients completed ODI and NDI, and complaints were recorded as back pain (BP), neck pain (NP), or both (BNP). Questionnaire scores were compared across cohorts via descriptives and Spearman (ρ) correlations. In exploring the feasibility of merging ODI/NDI, TDI was constructed from 9 ODI and 5 NDI items. Extracting questions from TDI, reconstructed 9-item rODI and 10-item rNDI indices were formed and compared with true ODI/NDI. RESULTS.There were a total of 1207 patients741 BP, 134 NP, and 268 BNP. Mean ODI was 37 ± 21 and mean NDI was 32 ± 21. Patients with concurrent BP and NP had significantly more disability. Seventy-eight patients of 134 (58%) patients with NP only had at least “moderate disability” by ODI and 297 of 741 (40%) patients with back pain only, had at least “moderate disability” by NDI. ODI versus NDI correlation was ρ = 0.755; ODI versus reconstructed rODI correlated at ρ = 0.985, and NDI versus reconstructed rNDI correlated at ρ = 0.967 (P &lt; 0.01). CONCLUSION.Elevated ODI/NDI scores in patients with isolated complaints show that disability in 1 region affects scores on both surveys. This study constructed a 14-item TDI that represents every domain of ODI/NDI with exception of ODI “Sex Life.” From this TDI, reconstructed scores correlated near perfectly with true scores. TDI provides a more global assessment of spinal disability and is a questionnaire that reduces the time burden to patients. The TDI allows for simultaneous assessment of back, neck, and global spinal disability.Level of Evidence2</description><identifier>ISSN: 0362-2436</identifier><identifier>EISSN: 1528-1159</identifier><identifier>DOI: 10.1097/BRS.0000000000001159</identifier><identifier>PMID: 26335678</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Back Pain - epidemiology ; Back Pain - physiopathology ; Disability Evaluation ; Female ; Humans ; Male ; Middle Aged ; Neck Pain - epidemiology ; Neck Pain - physiopathology ; Quality of Life ; Retrospective Studies ; Severity of Illness Index</subject><ispartof>Spine (Philadelphia, Pa. 1976), 2016-01, Vol.41 (1), p.74-81</ispartof><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3569-82cbe3828176249e431a3a9c231f2013086955054fb81f8b9bfadf7d83eb2033</citedby><cites>FETCH-LOGICAL-c3569-82cbe3828176249e431a3a9c231f2013086955054fb81f8b9bfadf7d83eb2033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26335678$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Spiegel, Matthew A</creatorcontrib><creatorcontrib>Lafage, Renaud</creatorcontrib><creatorcontrib>Lafage, Virginie</creatorcontrib><creatorcontrib>Ryan, Devon</creatorcontrib><creatorcontrib>Marascalchi, Bryan</creatorcontrib><creatorcontrib>Trimba, Yuriy</creatorcontrib><creatorcontrib>Ames, Christopher</creatorcontrib><creatorcontrib>Harris, Bradley</creatorcontrib><creatorcontrib>Tanzi, Elizabeth</creatorcontrib><creatorcontrib>Oren, Jonathan</creatorcontrib><creatorcontrib>Vira, Shaleen</creatorcontrib><creatorcontrib>Errico, Thomas</creatorcontrib><creatorcontrib>Schwab, Frank</creatorcontrib><creatorcontrib>Protopsaltis, Themistocles S</creatorcontrib><title>Developing the Total Disability Index Based on an Analysis of the Interrelationships and Limitations of Oswestry and Neck Disability Index</title><title>Spine (Philadelphia, Pa. 1976)</title><addtitle>Spine (Phila Pa 1976)</addtitle><description>STUDY DESIGN.Retrospective. OBJECTIVE.This study assessed the feasibility of combining Oswestry and Neck Disability Index (ODI and NDI) into 1 shorter “Total Disability Index” (TDI) from which reconstructed scores could be computed. SUMMARY OF BACKGROUND DATA.ODI and NDI are not pure assessments of disability related to back and neck, respectively. Because of similarities/redundancies of questions, ODI scores may be elevated in neck-pain patients and the converse is true for NDI in back-pain patients. METHODS.Spine patients completed ODI and NDI, and complaints were recorded as back pain (BP), neck pain (NP), or both (BNP). Questionnaire scores were compared across cohorts via descriptives and Spearman (ρ) correlations. In exploring the feasibility of merging ODI/NDI, TDI was constructed from 9 ODI and 5 NDI items. Extracting questions from TDI, reconstructed 9-item rODI and 10-item rNDI indices were formed and compared with true ODI/NDI. RESULTS.There were a total of 1207 patients741 BP, 134 NP, and 268 BNP. Mean ODI was 37 ± 21 and mean NDI was 32 ± 21. Patients with concurrent BP and NP had significantly more disability. Seventy-eight patients of 134 (58%) patients with NP only had at least “moderate disability” by ODI and 297 of 741 (40%) patients with back pain only, had at least “moderate disability” by NDI. ODI versus NDI correlation was ρ = 0.755; ODI versus reconstructed rODI correlated at ρ = 0.985, and NDI versus reconstructed rNDI correlated at ρ = 0.967 (P &lt; 0.01). CONCLUSION.Elevated ODI/NDI scores in patients with isolated complaints show that disability in 1 region affects scores on both surveys. This study constructed a 14-item TDI that represents every domain of ODI/NDI with exception of ODI “Sex Life.” From this TDI, reconstructed scores correlated near perfectly with true scores. TDI provides a more global assessment of spinal disability and is a questionnaire that reduces the time burden to patients. The TDI allows for simultaneous assessment of back, neck, and global spinal disability.Level of Evidence2</description><subject>Back Pain - epidemiology</subject><subject>Back Pain - physiopathology</subject><subject>Disability Evaluation</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neck Pain - epidemiology</subject><subject>Neck Pain - physiopathology</subject><subject>Quality of Life</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><issn>0362-2436</issn><issn>1528-1159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kclOwzAQhi0EglJ4A4R85BLwksU-tqyVKipB75GTTKjBjYudUvoKPDXuAkIgMRePxt8_M5ofoRNKzimR2UX_4fGc_AhKE7mDOjRhIlrlu6hDeMoiFvP0AB16_xyglFO5jw5YynmSZqKDPq7gDYyd6eYJtxPAY9sqg6-0V4U2ul3iQVPBO-4rDxW2DVYN7jXKLL322NZryaBpwTkwqtW28RM984Gq8FBPdbuprciRX4Bv3XL9dw_ly58hR2ivVsbD8fbtovHN9fjyLhqObgeXvWFUhp1lJFhZABdM0CxlsYSYU8WVLBmnNSOUE5HKJCFJXBeC1qKQRa2qOqsEh4IRzrvobNN25uzrPOyUT7UvwRjVgJ37nGYJjUWSSRLQeIOWznrvoM5nTk-VW-aU5CsT8mBC_tuEIDvdTpgXU6i-RV9XD4DYAAtrwu38i5kvwOUTUKad_N_7E1W6lDM</recordid><startdate>201601</startdate><enddate>201601</enddate><creator>Spiegel, Matthew A</creator><creator>Lafage, Renaud</creator><creator>Lafage, Virginie</creator><creator>Ryan, Devon</creator><creator>Marascalchi, Bryan</creator><creator>Trimba, Yuriy</creator><creator>Ames, Christopher</creator><creator>Harris, Bradley</creator><creator>Tanzi, Elizabeth</creator><creator>Oren, Jonathan</creator><creator>Vira, Shaleen</creator><creator>Errico, Thomas</creator><creator>Schwab, Frank</creator><creator>Protopsaltis, Themistocles S</creator><general>Copyright Wolters Kluwer Health, Inc. 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OBJECTIVE.This study assessed the feasibility of combining Oswestry and Neck Disability Index (ODI and NDI) into 1 shorter “Total Disability Index” (TDI) from which reconstructed scores could be computed. SUMMARY OF BACKGROUND DATA.ODI and NDI are not pure assessments of disability related to back and neck, respectively. Because of similarities/redundancies of questions, ODI scores may be elevated in neck-pain patients and the converse is true for NDI in back-pain patients. METHODS.Spine patients completed ODI and NDI, and complaints were recorded as back pain (BP), neck pain (NP), or both (BNP). Questionnaire scores were compared across cohorts via descriptives and Spearman (ρ) correlations. In exploring the feasibility of merging ODI/NDI, TDI was constructed from 9 ODI and 5 NDI items. Extracting questions from TDI, reconstructed 9-item rODI and 10-item rNDI indices were formed and compared with true ODI/NDI. RESULTS.There were a total of 1207 patients741 BP, 134 NP, and 268 BNP. Mean ODI was 37 ± 21 and mean NDI was 32 ± 21. Patients with concurrent BP and NP had significantly more disability. Seventy-eight patients of 134 (58%) patients with NP only had at least “moderate disability” by ODI and 297 of 741 (40%) patients with back pain only, had at least “moderate disability” by NDI. ODI versus NDI correlation was ρ = 0.755; ODI versus reconstructed rODI correlated at ρ = 0.985, and NDI versus reconstructed rNDI correlated at ρ = 0.967 (P &lt; 0.01). CONCLUSION.Elevated ODI/NDI scores in patients with isolated complaints show that disability in 1 region affects scores on both surveys. This study constructed a 14-item TDI that represents every domain of ODI/NDI with exception of ODI “Sex Life.” From this TDI, reconstructed scores correlated near perfectly with true scores. TDI provides a more global assessment of spinal disability and is a questionnaire that reduces the time burden to patients. The TDI allows for simultaneous assessment of back, neck, and global spinal disability.Level of Evidence2</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>26335678</pmid><doi>10.1097/BRS.0000000000001159</doi><tpages>8</tpages></addata></record>
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subjects Back Pain - epidemiology
Back Pain - physiopathology
Disability Evaluation
Female
Humans
Male
Middle Aged
Neck Pain - epidemiology
Neck Pain - physiopathology
Quality of Life
Retrospective Studies
Severity of Illness Index
title Developing the Total Disability Index Based on an Analysis of the Interrelationships and Limitations of Oswestry and Neck Disability Index
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