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Chiropractic Research Review

Usefulness of Patient Outcome Questionnaires

Patient perspectives are becoming increasingly more important in the evaluation of treatment outcomes, particularly in assessing the effectiveness of clinical interventions on current health status.

While validity and reliability have been established in a number of commonly used health questionnaires, their ability to accurately gauge functional changes over time are not as well documented in the literature.

Researchers recruited 350 patients from two orthopedic back pain clinics for a study designed to compare the responsiveness of eight scales and two summary scales. The SF-36 questionnaire, Oswestry Disability Index (ODI) and the Low Back Outcome Score questionnaire (LBOS) were included in the study. Patients completed pretreatment questionnaires one month before treatment; a follow-up questionnaire at least 2-6 months after treatment was used to rate change in response to treatment on a seven-point scale (much better = 1, much worse = 7).

Results: Most of the scales used in the study proved responsive to changes in health status, particularly for patients with low back pain and sciatica. The disease-specific questionnaires showed the greatest overall responsiveness (i.e., the ODI). However, a subscale of the SF-36 (designed to assess physical functioning) was more sensitive to change than the ODI or the LBOS for patients whose health status improved or remained unchanged. As the authors note, these results suggest that the SF-36 can be useful in the assessment of patients with low back pain when combined with disease-specific questionnaires.

Taylor SJ, Taylor AE, Foy MA, et al. Responsiveness of common measures for patients with low back pain. Spine, Sept. 1, 1999:24(17), pp1805-1812.

Chiropractic Research Review

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