Comparison of the EuroQOL-5D with the Oswestry Disability Index, back and leg pain scores in patients with degenerative lumbar spine pathology
Abstract
STUDY DESIGN: Cross-sectional study. OBJECTIVE: To evaluate the response behavior of EuroQOL-5D (EQ-5D) compared with the Oswestry Disability Index (ODI), and back and leg pain scores. SUMMARY OF BACKGROUND DATA: Recent changes in policies have highlighted the need for demonstration of both quality and cost effectiveness. In an effort to meet these requirements, surgeons are collecting health-related quality of life and utility data. Unfortunately, the burden of extensive data collection on both physician and patient is considerable. The EQ-5D is a commonly used, easily administered, brief utility measure that can provide both clinical and utility data. The EQ-5D has not yet been validated in spine patients in comparison with established outcome measures. METHODS: EQ-5D, ODI, back and leg pain (0-10) scores were collected as part of standard clinical practice. Spearman rank correlations between the ODI, back and leg pain scores, and the EQ-5D were determined. A subanalysis to determine dimension-specific effects was done. Data were categorized by level of low back disability and level of back and leg pain. RESULTS: Data from 8385 patients (5046 females, 3339 males), mean age 52 (range, 18-96) were analyzed. There was a strong correlation between EQ-5D and ODI (r = -0.776) and between EQ-5D and back pain (r = -0.648); and moderate correlation between EQ-5D and leg pain scores (r = -0.538). Increasing disability, as measured by ODI, lead to lower EQ-5D scores, with similar response behavior for both back and leg pain scores. All correlations were statistically significant at P < 0.0001. CONCLUSION: The EQ-5D correlated well with established spine outcome measures, including ODI, and back and leg pain scores. EQ-5D correlated best with ODI scores. Correlation with back pain was stronger than leg pain, but all correlations were relatively strong. The EQ-5D can serve spine surgeons as an effective measure of clinical outcome and health utility for economic analysis.
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Low quality evidence for inconsistent results for EQ-5D-3L domain scores.
“For the domain scores, low quality evidence (due to risk of bias) was found for inconsistent results (Table 3) because two studies of doubtful quality reported inconsistent results [45,57].”
From Evidence on the measurement properties of health-related quality of life instruments is largely missing in patients with low back pain: A systematic review (2018) · cites this paper as [57]
Cites
Oswestry Low Back Pain Disability Questionnaire
Fairbank, J. C. T., Couper, J., Davies, J. B., & O'Brien, J. P. (2006) · Springer eBooks · doi:10.1007/978-3-540-29805-2_3023 · Cited by 3,954 · see citing works
The estimation of a preference-based measure of health from the SF-36.
Brazier, J., Roberts, J., & Deverill, M. (2002) · Journal of Health Economics · doi:10.1016/s0167-6296(01)00130-8 · Cited by 3,164 · see citing works
Laupacis, A., Feeny, D. H., Detsky, A. S., & Tugwell, P. (1992) · Europe PMC (PubMed Central) · Cited by 1,581 · see citing works
Multiattribute and Single-Attribute Utility Functions for the Health Utilities Index Mark 3 System
Feeny, D. F., Furlong, W. J., Torrance, G. W., Goldsmith, C. H., Zhu, Z., Depauw, S., Denton, M. A., & Boyle, M. (2002) · Medical Care · doi:10.1097/00005650-200202000-00006 · Cited by 1,333 · see citing works
Revised Oswestry Disability Questionnaire
Fairbank, J. C. T. (2000) · Spine · doi:10.1097/00007632-200010010-00025 · Cited by 171 · see citing works
Carreon, L. Y., Glassman, S. D., McDonough, C. M., Rampersaud, R. Y., Berven, S., & Shainline, M. R. (2009) · Spine · doi:10.1097/brs.0b013e3181a93ea6 · Cited by 74 · see citing works
Self-citationUse of formal benefit/cost evaluations in health system decision making.
Bloom, B. S. (2004) · PubMed · Cited by 43 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
A proposed set of metrics for standardized outcome reporting in the management of low back pain
Clement, R. C., Welander, A., Stowell, C. J., Cha, T. D., Chen, J. L., Davies, M., Fairbank, J. C. T., Foley, K. T., Gehrchen, M., Hägg, O., et al. (2015) · Acta Orthopaedica · doi:10.3109/17453674.2015.1036696 · Cited by 172 · see citing works
Choosing the right outcome measurement instruments for patients with low back pain
Chiarotto, A., Terwee, C. B., & Ostelo, R. (2016) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2017.07.001 · Cited by 108 · see citing works
Diabetes Is Related to Worse Patient-Reported Outcomes at Two Years Following Spine Surgery
Armaghani, S. J., Archer, K. R., Rolfe, R. C., Demaio, D. N., & Devin, C. J. (2016) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.o.00297 · Cited by 87 · see citing works
Chiarotto, A., Terwee, C. B., Kamper, S. J., Boers, M., & Ostelo, R. W. (2018) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2018.05.006 · Cited by 69 · see citing works
Quality of Life in Patients with Osteoporotic Vertebral Compression Fractures
Jung, H. J., Park, Y., Seo, H.-Y., Lee, J., An, K.-C., Kim, J.-H., Shin, B.-J., Kang, T. W., & Park, S.-Y. (2017) · Journal of Bone Metabolism · doi:10.11005/jbm.2017.24.3.187 · Cited by 63 · see citing works
Do we have the right PROMs for measuring outcomes in lumbar spinal surgery?
Stokes, O. M., Cole, A., Breakwell, L. M., Lloyd, A., Leonard, C., & Grevitt, M. P. (2017) · European Spine Journal · doi:10.1007/s00586-016-4938-x · Cited by 48 · see citing works
Asher, A. L., Chotai, S., Devin, C. J., Speroff, T., Harrell, F. E., Nian, H., Dittus, R. S., Mummaneni, P. V., Knightly, J. J., Glassman, S. D., et al. (2016) · Journal of Neurosurgery Spine · doi:10.3171/2015.11.spine15872 · Cited by 48 · see citing works
Self-citationMensah, E. O., Chalif, J. I., Baker, J. G., Chalif, E. J., Biundo, J., & Groff, M. W. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13185460 · Cited by 41 · see citing works
Quality of life after en bloc resection of tumors in the mobile spine
Colman, M. W., Karim, S. M., Lozano‐Calderón, S. A., Pedlow, F. X., Raskin, K. A., Hornicek, F. J., & Schwab, J. H. (2015) · The Spine Journal · doi:10.1016/j.spinee.2015.03.042 · Cited by 40 · see citing works
Park, P., McGirt, M. J., Bekelis, K., Holland, C. M., Davies, J. M., Devin, C. J., Atkins, T. G., Knightly, J. J., Groman, R. F., Zyung, I., et al. (2015) · Neurosurgical FOCUS · doi:10.3171/2015.9.focus15355 · Cited by 41 · see citing works
Patient-Reported Outcome Measures in Neurosurgery: A Review of the Current Literature
Ghimire, P., Hasegawa, H., Kalyal, N., Hurwitz, V., & Ashkan, K. (2017) · Neurosurgery · doi:10.1093/neuros/nyx547 · Cited by 34 · see citing works
Measurement Properties of the Oswestry Disability Index in Recipients of Lumbar Spine Surgery
Cook, C. E., Garcia, A. N., Wright, A. A., Shaffrey, C. I., & Gottfried, O. N. (2020) · Spine · doi:10.1097/brs.0000000000003732 · Cited by 36 · see citing works
Burgstaller, J. M., Wertli, M. M., Ulrich, N. H.-B., Pichierri, G., Brunner, F., Farshad, M., Porchet, F., Steurer, J., & Gravestock, I. (2020) · Spine · doi:10.1097/brs.0000000000003501 · Cited by 33 · see citing works
Pennington, Z. A., Sundar, S. J., Lubelski, D., Alvin, M. D., Benzel, E. C., & Mroz, T. E. (2019) · Journal of Clinical Neuroscience · doi:10.1016/j.jocn.2019.07.025 · Cited by 29 · see citing works
Beauchamp-Chalifour, P., Flexman, A. M., Street, J., Fisher, C. G., Ailon, T. T., Dvorak, M. F., Kwon, B. K., Paquette, S. J., Dea, N., & Charest-Morin, R. (2021) · Journal of Neurosurgery Spine · doi:10.3171/2021.2.spine201879 · Cited by 26 · see citing works
Health‐related Quality of Life in Patients with Metastatic Spinal Cord Compression
Morgen, S. S., Engelholm, S. A., Larsen, C. F., Søgaard, R., & Dahl, B. (2016) · Orthopaedic Surgery · doi:10.1111/os.12253 · Cited by 26 · see citing works
Lumbar Spinal Stenosis: Objective Measurement Scales and Ambulatory Status
Abou‐Al‐Shaar, H., Adogwa, O., & Mehta, A. I. (2018) · Asian Spine Journal · doi:10.31616/asj.2018.12.4.765 · Cited by 22 · see citing works
True Differences in Poor Outcome Risks Between Revision and Primary Lumbar Spine Surgeries
Cook, C. E., Garcia, A. N., Park, C., & Gottfried, O. N. (2021) · HSS Journal® The Musculoskeletal Journal of Hospital for Special Surgery · doi:10.1177/1556331621995136 · Cited by 21 · see citing works
Kim, C. H., Chung, C. K., Choi, Y., Shin, H.-J., Woo, J. W., Kim, S.-M., & Lee, H. (2016) · The Spine Journal · doi:10.1016/j.spinee.2016.02.048 · Cited by 18 · see citing works
VanHorn, T. A., Knio, Z. O., & O’Gara, T. (2020) · The International Journal of Spine Surgery · doi:10.14444/7071 · Cited by 13 · see citing works
Sabou, S., Carrasco, R., Verma, R., Siddique, I., & Mohammad, S. (2019) · Journal of Spine Surgery · doi:10.21037/jss.2019.12.02 · Cited by 12 · see citing works
Smuck, M. W., McCormick, Z. L., Gilligan, C. J., Hailey, M. K., Quinn, M. L., Bentley, A., Metcalfe, K., Bradbury, B., Lukes, D., & Taylor, R. S. (2024) · The Spine Journal · doi:10.1016/j.spinee.2024.09.016 · Cited by 11 · see citing works
Sabou, S., Lagaras, A., Verma, R., Siddique, I., & Mohammad, S. (2019) · Journal of Neurosurgery Spine · doi:10.3171/2019.1.spine18754 · Cited by 11 · see citing works
Calek, A., Hochreiter, B., & Buckland, A. J. (2024) · The Spine Journal · doi:10.1016/j.spinee.2024.03.018 · Cited by 10 · see citing works
Cook, C. E., Garcia, A. N., Shaffrey, C. I., & Gottfried, O. N. (2020) · Spine Surgery and Related Research · doi:10.22603/ssrr.2020-0156 · Cited by 10 · see citing works
Postoperative complications: how much do they cost?
de la Hunt, M. N., Chan, A. Y. T., & Karran, S. J. (1986) · PubMed Central · Cited by 10 · see citing works
Rodrigues, R., Silva, P. S., Cunha, M., Vaz, R. M., & Pereira, P. (2018) · World Neurosurgery · doi:10.1016/j.wneu.2018.04.174 · Cited by 9 · see citing works
Long term outcome and fusion rate of transdiscal fixation for L5-S1 high grade spondylolisthesis
Delgado-Fernández, J., Frade-Porto, N., Blasco, G., González-Tarno, P., Gil-Simoes, R., Pulido, P., & de Sola, R. G. (2021) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2021.106898 · Cited by 7 · see citing works
Ben, Â. J., Pellekooren, S., Bosmans, J. E., Ostelo, R., Maas, E. T., Alili, M. E., van Tulder, M. W., Huygen, F. J. P. M., Oosterhuis, T., Apeldoorn, A. T., et al. (2023) · Value in Health · doi:10.1016/j.jval.2023.01.020 · Cited by 7 · see citing works
Rundell, S. D., Bresnahan, B. W., Heagerty, P. J., Comstock, B. A., Friedly, J. L., Jarvik, J. G., & Sullivan, S. D. (2014) · Medical Decision Making · doi:10.1177/0272989x14533995 · Cited by 7 · see citing works
Membrane-Stabilizing Agents Improve Quality-of-Life Outcomes for Patients with Lumbar Stenosis
Bansal, S. K., Lubelski, D., Thompson, N. R., Shah, A. A., Mazanec, D. J., Benzel, E. C., & Khalaf, T. M. (2015) · Global Spine Journal · doi:10.1055/s-0035-1557144 · Cited by 6 · see citing works
Yu, H., Malhotra, K., Butler, J. S., Patel, A., Sewell, M. D., Li, Y. Z., & Molloy, S. (2016) · The Bone & Joint Journal · doi:10.1302/0301-620x.98b9.37786 · Cited by 5 · see citing works
Kovacs, F. M., Royuela, A., Zamora, J., & Abraira, V. (2013) · Spine · doi:10.1097/brs.0b013e31829cb804 · Cited by 5 · see citing works
Garcia, A. N., Cook, C. E., & Gottfried, O. N. (2021) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2021.102424 · Cited by 4 · see citing works
Garcia, A. N., Simon, C. B., Yang, Z. L., Niedzwiecki, D., Cook, C. E., & Gottfried, O. N. (2021) · Health & Social Care in the Community · doi:10.1111/hsc.13584 · Cited by 4 · see citing works
Mahmoud, M. A., Afifi, A., Ghandour, M. A., Mert, Ü., Herren, C., Blume, C., Pishnamaz, M., Hildebrand, F., Oikonomidis, S., Sobottke, R., et al. (2024) · European Journal of Trauma and Emergency Surgery · doi:10.1007/s00068-024-02645-1 · Cited by 3 · see citing works
Knio, Z. O., VanHorn, T. A., & O’Gara, T. (2019) · World Neurosurgery · doi:10.1016/j.wneu.2019.10.124 · Cited by 3 · see citing works
Demetriades, A. K., Chowdhury, S. M., & Mavrovounis, G. (2023) · Journal of Craniovertebral Junction and Spine · doi:10.4103/jcvjs.jcvjs_38_23 · Cited by 2 · see citing works
Qretam, A., Ceuterick, J., Ghandour, M. A., Mert, Ü., Herren, C., Pishnamaz, M., Knobe, M., Hildebrand, F., Sobottke, R., & Mahmoud, M. A. (2025) · Medicina · doi:10.3390/medicina61020227 · Cited by 1 · see citing works
Important Research Principles in the Field of Spinal Osteotomy
Meredith, D. S., & Vaccaro, A. R. (2014) · Springer eBooks · doi:10.1007/978-94-017-8038-4_21 · Cited by 1 · see citing works
The History of Quality Assessment in Spine Care
Feuchtbaum, E., MacLean, C. H., & Albert, T. J. (2018) · Springer eBooks · doi:10.1007/978-3-319-97990-8_3 · Cited by 1 · see citing works
COMPARING PREOPERATIVE QUALITY OF LIFE QUESTIONNAIRE IN LUMBAR STENOSIS
Neto, S. M., Verde, E. C. L., Rosa, A. F., Lima, M. C., Cavali, P. T. M., Zuiani, G. R., Pasqualini, W., Tebet, M. A., & Neto, M. Í. R. (2023) · Coluna/Columna · doi:10.1590/s1808-185120222203272849
Musculoskeletal complaints in primary care
Pellekooren, S. (2023) · doi:10.5463/thesis.242
- Authors
- Mueller, B., Carreon, L. Y., & Glassman, S. D.
- Affiliations
- Norton Leatherman Spine (US)
- Corresponding author
- Carreon, Leah Y.
- Venue
- Spine
- Published
- 2013-04
- Volume
- 38
- Issue
- 9
- Pages
- 757-761
- ISSN
- 0362-2436 (ISSN-L)
- OpenAlex
- W1976418676
- Cited by
- 43
- References
- 7
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 4 · 2021: 5 · 2020: 4 · 2019: 4 · 2018: 4 · 2017: 3 · 2016: 6 · 2015: 4 · 2014: 2 · 2013: 1
- FWCI
- 5.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Spine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Keywords
- EuroQol-5D, EQ-5D, Oswestry Disability Index, back pain, leg pain, lumbar degenerative disease, health-related quality of life, health utility, outcome measure correlation, low back disability, spinal surgery outcomes
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Back Pain, Cross-Sectional Studies, Disability Evaluation, Female, Humans, Leg, Lumbar Vertebrae, Male, Middle Aged, Pain Measurement, Surveys and Questionnaires, Young Adult, Intervertebral Disc Degeneration
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