A Systematic Review of Head-to-Head Comparison Studies of the Roland-Morris and Oswestry Measures' Abilities to Assess Change

Abstract

Purpose: To determine if the sensitivity to change of Roland-Morris Questionnaire (RMQ) and Oswestry Disability Index (ODI) scores differ when applied to patients with low back pain (LBP). A secondary purpose was to critique the methodological rigour of the identified head-to-head comparison studies. Methods: A systematic review of five online databases was performed to locate head-to-head comparison studies of the RMQ and the ODI that assessed the sensitivity to change of the two measures. Studies were eligible if they met a pre-determined set of inclusion criteria. A newly developed quality criteria form was used to evaluate the methodological rigour of head-to-head comparison studies. Results: Nine articles met the inclusion criteria. Although there was a statistically significant difference in favour of the RMQ for two studies, there was no apparent consistent advantage of one measure over the other. Frequent methodological deficiencies included no formal sample size calculation, no formal between-measure comparison, and no independent reference standard. Conclusion: There was no consistent evidence supporting one measure over the other. Many studies displayed methodological deficiencies.Key Words: self-report; sensitivity and specificity; systematic review; reproducibility of results. RÉ SUMÉObjectif : Dé terminer si la sensibilité au changement des ré sultats au questionnaire Roland-Morris (Roland-Morris Questionnaire, RMQ) et au questionnaire d'incapacité d'Oswestry (Oswestry Disability Index, ODI) diffè rent lorsqu'on les applique aux patients qui souffrent de lombalgie. Comme objectif secondaire, ré aliser une analyse critique de la rigueur mé thodologique des é tudes comparatives directes sé lectionné es. Mé thode : Une revue systé matique de cinq bases de donné es en ligne a é té ré alisé e pour rechercher des é tudes comparatives directes du RMQ et de l'ODI qui é valuaient la sensibilité au changement de ces deux mesures. Les é tudes é taient retenues si elles satisfaisaient à un ensemble de critè res d'inclusion pré é tabli. Un formulaire de critè res de qualité nouvellement é laboré a é té utilisé pour é valuer la rigueur mé thodologique des é tudes comparatives directes. Ré sultats : Neuf articles satisfaisaient aux critè res d'inclusion. Bien que pour deux é tudes, on ait constaté une diffé rence statistique appré ciable favorable au RQM, il n'y avait aucun avantage apparent commun pour une mesure plutô t que pour l'autre. Les lacunes mé thodologiques fré quentes é taient notamment l'absence de calcul formel de la taille de l'é chantillon, l'absence de critè re pour la comparaison des mesures et le fait qu'il n'y avait aucune norme de ré fé rence indé pendante. Conclusion : Il n'y a aucun é lé ment probant commun permettant de privilé gier une mesure plutô t qu'une autre. Plusieurs é tudes comportaient des lacunes sur le plan mé thodologique.The past three decades have seen a growing number of patient-reported outcome measures for persons with low back pain (LBP). 1-4 A challenge for clin...

Roland-Morris Disability Questionnaire, Oswestry Disability Index, and Quebec Back Pain Disability Scale: Which Has Superior Measurement Properties in Older Adults With Low Back Pain?

“…7 In recent systematic reviews of head-to-head comparisons, there was no single instrument (RMDQ, ODI, or QBPDS) that came out on top in terms of measurement properties. 7,32 All failed in some key measurement aspects 8 : issues with the unidimensionality of the total score (which is routinely used) and with measurement error (measured as the smallest detectable change [SDC]), which is usually larger than 20% of the score range. 7,8,44 Few studies have focused on the measurement properties of the RMDQ, ODI, and QBPDS in older adults (older than 65 years) with LBP.…”

A Roland Morris Disability Questionnaire Target Value to Distinguish between Functional and Dysfunctional States in People with Low Back Pain

“…The RMQ is a commonly used patient-reported outcome measure 1 that assesses pain-related functional status; its measurement properties are consistent with or better than those of competing measures. 8 A body of work has estimated threshold change scores for the RMQ using both reliability-based and diagnostic test methodologies. 9 – 13 Typical estimates of true and important change for the RMQ are around 5 points.…”

Effectiveness of Kinesiotaping and Conventional Physiotherapy on Patients With Non-Specific Chronic Low Back Pain

“…The results of these studies showed that Visual Analogue Scale for Pain (VAS) and Roland Morris Questionnaire are valid instruments which are commonly used to assess the outcomes of the disease in patients with LBP. The results also indicated that these questionnaires had appropriate reliability and validity to assess pain and disability in patients with LBP [27][28][29].…”