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Cited by 134Musculoskeletal pain and rehabilitationHealth Systems, Economic Evaluations, Quality of LifeSpine and Intervertebral Disc Pathology

Use of health status measures in patients with low back pain in clinical settings. Comparison of specific, generic and preference-based instruments

Suarez‐Almazor, M. E., Kendall, C., Johnson, J. A., Skeith, K., Vincent, D.·2000·Rheumatology
DOI 10.1093/rheumatology/39.7.783
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Abstract

OBJECTIVE: To evaluate the discriminative performance over time of specific, generic and preference-based instruments in patients with low back pain (LBP) in clinical settings. METHODS: Forty-six consecutive patients with LBP participated in the study. Self-response questionnaires were administered at baseline and 3 and 6 months, including the following instruments: Oswestry (specific for LBP), SF-36 (generic), EuroQol (EQ-5D) and Health Utilities Index (HUI) (preference-based). EQ-5D and HUI weights were derived from previously published evaluations in the general population. Patients were asked to compare their health status with their baseline health and were categorized on the basis of an ordinal scale as: (a) improved; (b) stable; or (c) worse. Changes in the instruments were evaluated by rescaling the instruments over the same scale interval and by estimating standardized effect sizes between two time points for the three categories of change. RESULTS: Thirty-seven patients (80%) completed both the baseline and the 3-month questionnaire and 34 the baseline and 6-month questionnaires (74%). Overall, at both time points, approximately half of the patients reported no changes in their health status. Correlations between instruments were generally low, suggesting that they measure different health domains. The scales which discriminated best between patients who improved and those who deteriorated at 3 months were the Oswestry, the HUI, the EQ-5D and the SF-36 bodily pain and emotional role subscales. The SF-36 subscales appeared to have a floor effect for those patients who had deteriorated. CONCLUSIONS: Most SF-36 subscales did not adequately reflect changes in the health status of patients with LBP, mostly for those who reported deterioration. Preference-derived quality-of-life scores appeared to discriminate among patients who improved and those who deteriorated, although not as consistently as the disease-specific measure (Oswestry). Additional research is needed to evaluate the role of generic measures of quality of life in the assessment of patients with LBP before they can be widely implemented in clinical settings or outcomes research.

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Crossref · 10.1093/rheumatology/39.7.783

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Authors
Suarez‐Almazor, M. E., Kendall, C., Johnson, J. A., Skeith, K., & Vincent, D.
Affiliations
University of Alberta (CA)
ORCID
Johnson, J. A.
Venue
Rheumatology
Publisher
Oxford University Press (OUP)
Published
2000-07
Volume
39
Issue
7
Pages
783-790
ISSN
  • 1462-0324 (ISSN-L)
  • 1462-0332
DOI
10.1093/rheumatology/39.7.783
OpenAlex
W2146271699
Cited by
134
References
20
Citations by year
2025: 1 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 8 · 2019: 4 · 2018: 6 · 2017: 4 · 2016: 4 · 2015: 4 · 2014: 2 · 2013: 9 · 2012: 2
FWCI
3.02
Type
journal article
Language
en
Open access
closed
Locations
  • Lara D. Veeken (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
Keywords
low back pain, health indicators, Oswestry Disability Index, SF-36, EQ-5D, Health Utilities Index, preference-based health-related quality of life, generic health-related quality of life, floor effect, change detection, standardized effect size
MeSH terms
Data Collection, Female, Health Status Indicators, Health Surveys, Humans, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Low Back Pain, Disease Progression

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