Discriminative validity and responsiveness of the Oswestry Disability Index among Japanese outpatients with lumbar conditions

Abstract

The Oswestry Disability Index (ODI) is one of the most used assessment scales for patients with spine conditions, and translations into several languages have already been available. However, the scale's discriminative validity and responsiveness to the clinical change was somewhat understudied in these translated versions of the ODI. In this study, we independently developed a Japanese version of the ODI, and tested its discriminative and responsive performances among outpatients with various spinal conditions. We recruited 167 outpatients from seven participating clinics, and concurrently measured the translated ODI and MOS Short Form 36 (SF36) as a reference scale. We also obtained from medical records clinical information such as diagnoses, the past history of surgery, and existence of subjective symptoms and clinical signs. For testing discriminative validity, scores were compared by the number of symptoms and signs, with the trend test. Receiver operating characteristics (ROC) analysis was also conducted to compare ODI and SF36 in their performance to discriminate the existence of signs/symptoms, by chi-square test on the area under ROC curve (AUC). For 35 patients (17 clinically stable, 18 undergoing surgery and clinically significantly changed), the two scales were repeatedly administered after 3-6 months to compare responsiveness by using ROC analysis. The translated ODI and the SF36 Physical Function (PF) subscale showed a significant trend increase as the numbers of symptoms/signs increased. They also showed comparable performance in discriminating the existence of signs/symptoms (AUC=0.70-0.76 for ODI, 0.69-0.70 for SF36 PF, P=0.15-0.81), and clinical status change over time (AUC=0.82 for ODI, 0.72 for SF36 PF, P=0.31). Our results showed that the translated Japanese ODI showed fair discriminative validity and responsiveness as the original English scale showed.

Factor Structure and Concurrent/Convergent Validity of the Modified Somatic Perception Questionnaire and Pain Beliefs Instrument

“…If so, then a relationship with the baseline findings is necessary for further extrapolation to a long-term outcome. 39 There is some association between the elements of the PBSI and the outcome measures ODI/NDI and SF-36 PCS, an association that, although statistically significant, was only fair to moderate, 40 a finding that is consistent with previous studies that found that the strongest correlation between instruments is in the SF-36 physical function subscale in English, 41 Japanese, 42 and Turkish. 43 The weakest association in our study was between the ODI and the mental health component of the SF-36.…”

The quality of spine surgery from the patient’s perspective: Part 2. Minimal clinically important difference for improvement and deterioration as measured with the Core Outcome Measures Index

“…The accuracy (or discriminatory ability) of tests with AUCs 0.50-0.70 is generally considered low, between 0.70 and 0.90, moderate, and over 0.90, high [23]. The AUCs for the COMI were comparable to or even higher than those previously reported in the literature for back-specific instruments such as the Oswestry Disability Index (AUC 0.82-0.85) [6,13,16], the RolandMorris Disability Questionnaire (AUC 0.84) [16], or the pain intensity visual analog scale (AUC 0.88) [16] in patients undergoing spine surgery; they were also slightly higher than the AUC reported for the COMI during its initial validation studies in surgical patients (AUC 0.82) [15]. In the present study, individual ''improvement'' was predicted (with 81% sensitivity and 83% specificity) by a reduction in COMI score of 2.2 points or more.…”

Responsiveness of the Chinese version of the Oswestry disability index in patients with chronic low back pain

“…The responsiveness of the ODI has been compared between a number of different populations and context [3,5,10,12,15,24]. These studies have estimated an SRM between 0.3 and 1.2 for the ODI [5,9,10,15,24].…”