The Library
Responsiveness, reliability, and minimally important and minimal detectable change of three electronic patient reported outcome measures for low back pain : a validation study
Tools
Froud, Robert J., Fawkes, Carol, Foss, Jonathan G. K., Underwood, Martin and Carnes, Dawn (2018) Responsiveness, reliability, and minimally important and minimal detectable change of three electronic patient reported outcome measures for low back pain : a validation study. Journal of Medical Internet Research . doi:10.2196/jmir.9828 ISSN 1438-8871.
|
PDF
WRAP-responsiveness-minimally-detectable-change-Froud-2018.pdf - Accepted Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (1015Kb) | Preview |
Official URL: http://dx.doi.org/10.2196/jmir.9828
Abstract
Background
The Roland Morris Disability Scale (RMDQ), Visual Analogue Scale of pain intensity (VAS) and Numerical Rating Scale (NRS) are among the most commonly used outcome measures in trials of interventions for low back pain. Their use in paper form is well-established. Few data are available on the metric properties of electronic counterparts.
Objective
To establish responsiveness, minimal important change (MIC) thresholds, reliability, and minimal detectable change (MDC95) for electronic (e) versions of the RMDQ, VAS, and NRS as delivered via iOS app, Android app, and web app.
Methods
We recruited people with low back pain who visited osteopaths. We invited participants to complete the eRMDQ, eVAS, and eNRS at baseline, one-week, and six-weeks, along with a health transition question (TQ) at one and six-weeks. Data from participants reporting recovery were used in responsiveness and MIC analyses, using Receiver Operator Characteristic curves. Data from participants reporting stability were used for analyses of reliability (ICC agreement) and minimal detectable change (MDC95).
Results
We included 442 participants. At one and then six-weeks, ROC AUCs were 0.69 (95%CI 0.59 to 0.80) then 0.67 (0.46 to 0.87) for the eRMDQ; 0.69 (0.58 to 0.80) then 0.74 (0.53 to 0.95) for the eVAS; and 0.73 (0.66 to 0.80) then 0.81 (0.69 to 0.92) for the eNRS. Associated MIC thresholds were estimated as 1 (0 to 2) then 2 (-1 to 5), 13 (9 to 17) then 7 (-12 to 26), and 2 (1 to 3) then 1 (0 to 2) points, respectively. Over one-week in stable and ‘about the same’ participants ICCs were 0.87 (0.66 to 0.95) and 0.84 (0.73 to 0.91) for the eRMDQ, with MDC95 of 4 and 5; 0.31 (-0.25 to 0.71) and 0.61 (0.36 to 0.77) for the eVAS with MDC95 of 39 and 34; and 0.52 (0.14 to 0.77) to 0.67 (0.51 to 0.78) with MDC95 of 4 and 3 for the eNRS.
Conclusions
The eRMDQ was reliable with borderline adequate responsiveness. The eNRS was responsive with borderline reliability. While the eVAS had adequate responsiveness it did not have an attractive reliability profile. Thus, the eNRS might be preferred over the eVAS for measuring pain intensity. The observed electronic outcome measures’ metric properties are within the range of values reported in the literature for their paper counterparts and are adequate for measuring changes in a low back pain population.
Item Type: | Journal Article | ||||||||
---|---|---|---|---|---|---|---|---|---|
Subjects: | R Medicine > RD Surgery | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Science > Computer Science Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
||||||||
Library of Congress Subject Headings (LCSH): | Backache -- Diagnosis, Back -- Diseases, Medical informatics | ||||||||
Journal or Publication Title: | Journal of Medical Internet Research | ||||||||
Publisher: | JMIR Publications | ||||||||
ISSN: | 1438-8871 | ||||||||
Official Date: | 2018 | ||||||||
Dates: |
|
||||||||
DOI: | 10.2196/jmir.9828 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Date of first compliant deposit: | 26 July 2018 | ||||||||
Date of first compliant Open Access: | 24 September 2018 | ||||||||
RIOXX Funder/Project Grant: |
|
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year