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Outcome Measures for Low Back Pain Research: A Proposal for Standardized Use
Abstract
STUDY DESIGN: An international group of back pain researchers considered recommendations for standardized measures in clinical outcomes research in patients with back pain. OBJECTIVES: To promote more standardization of outcome measurement in clinical trials and other types of outcomes research, including meta-analyses, cost-effectiveness analyses, and multicenter studies. SUMMARY OF BACKGROUND DATA: Better standardization of outcome measurement would facilitate comparison of results among studies, and more complete reporting of relevant outcomes. Because back pain is rarely fatal or completely cured, outcome assessment is complex and involves multiple dimensions. These include symptoms, function, general well-being, work disability, and satisfaction with care. METHODS: The panel considered several factors in recommending a standard battery of outcome measures. These included reliability, validity, responsiveness, and practicality of the measures. In addition, compatibility with widely used and promoted batteries such, as the American Academy of Orthopaedic Surgeons Lumbar Cluster were considered to minimize the need for changes when these instruments are used. RESULTS: First, a six-item set was proposed, which is sufficiently brief that it could be used in routine care settings for quality improvement and for research purposes. An expanded outcome set, which would provide more precise measurement for research purposes, includes measures of severity and frequency of symptoms, either the Roland or the Oswestry Disability Scale, either the SF-12 or the EuroQol measure of general health status, a question about satisfaction with symptoms, three types of "disability days," and an optional single item on overall satisfaction with medical care. CONCLUSION: Standardized measurement of outcomes would facilitate scientific advances in clinical care. A short, 6-item questionnaire and a somewhat expanded, more precise battery of questionnaires can be recommended. Although many considerations support such recommendations, more data on responsiveness and the minimally important change in scores are needed for most of the instruments.
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“The secondary outcome measures selected were those that had the potential to be primary or secondary outcomes of a potential full clinical trial, based on the core outcome sets recommended for LBP.39 40”
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Self-citationSimplifying Outcome Measurement
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Self-citation
Metadata
- Authors
- Deyo, R. A., Battie, M., Beurskens, A. J. H. M., Bombardier, C., Croft, P., Koes, B., Malmivaara, A., Roland, M., Von Korff, M., & Waddell, G.
- Affiliations
- University of Washington (US)
- University of Manchester (GB)
- Group Health Cooperative (US)
- Keele University (GB)
- Amsterdam Public Health (NL)
- University of Alberta (CA)
- Corresponding author
- Deyo, Richard A.
- Venue
- Spine
- Published
- 1998-09
- Volume
- 23
- Issue
- 18
- Pages
- 2003-2013
- ISSN
- 0362-2436 (ISSN-L)
- OpenAlex
- W2145513209
- Cited by
- 1,229
- References
- 17
- Citations by year
- 2026: 13 · 2025: 15 · 2024: 18 · 2023: 29 · 2022: 24 · 2021: 29 · 2020: 48 · 2019: 45 · 2018: 31 · 2017: 44 · 2016: 52 · 2015: 67 · 2014: 58 · 2013: 62 · 2012: 70
- FWCI
- 15.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Spine (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Funders
- Agency for Healthcare Research and Quality (HS 08194)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- low back pain, outcome measures, clinical trials, work disability, disability days, health-related quality of life, patient satisfaction, symptom severity, Oswestry Disability Index, SF-12, EuroQol, minimally important change, responsiveness
- MeSH terms
- Clinical Trials as Topic, Health Status Indicators, Humans, Quality of Life, Surveys and Questionnaires, Research, Outcome Assessment, Health Care, Low Back Pain
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