TY - JOUR
T1 - Validation of the work ability index-single item and the pain disability index-work item in patients with chronic low back pain
AU - Boekel, Imke
AU - Dutmer, Alisa L
AU - Schiphorst Preuper, Henrica R
AU - Reneman, Michiel F
N1 - © 2022. The Author(s).
PY - 2022/1/24
Y1 - 2022/1/24
N2 - PURPOSE: A cross-sectional and longitudinal study was conducted to analyse construct validity, responsiveness, and Minimal Clinically Important Change (MCIC) in the Work Ability Score (WAS) and Pain Disability Index Work item (PDI-W) in patients with Chronic Low Back Pain (CLBP).METHOD: Construct validity was assessed by testing predefined hypotheses. Responsiveness and MCIC were measured with an anchor-based method. The area under the receiver Operating Characteristic Curve (AUC) and the optimal cut-off point were calculated. Smallest Detectable Change (SDC) was calculated to determine measurement error.RESULTS: In total, 1502 patients (age 18-65 years) with CLBP were included. For validity of the WAS and PDI-W, respectively, seven and six out of 10 hypotheses were not rejected. The WAS (n = 355) was responsive to change with an AUC of 0.70. MCIC was 1.5 point, SDCindividual 4.9, and SDCgroup 0.3. MCICs were 4.5, 1.5, and - 0.5 points for, respectively, low, middle, and high scoring baseline groups. The PDI-W (n = 297) was responsive to change with an AUC of 0.80. MCIC was - 2.5 points, SDCindividual 5.2, and SDCgroup 0.3. MCICs were - 0.5, - 2.5, and - 4.5 points for, respectively, low, middle, and high scoring baseline groups.CONCLUSION: Construct validity of the WAS and PDI-W was insufficient in this patient sample. The WAS and PDI-W are responsive to change. On average, improvements of 1.5 point (WAS) and - 2.5 points (PDI-W) were interpreted as clinically important. However, MCICs are also baseline dependent. Due to a risk of measurement error, at the individual level change scores should be interpreted with caution.
AB - PURPOSE: A cross-sectional and longitudinal study was conducted to analyse construct validity, responsiveness, and Minimal Clinically Important Change (MCIC) in the Work Ability Score (WAS) and Pain Disability Index Work item (PDI-W) in patients with Chronic Low Back Pain (CLBP).METHOD: Construct validity was assessed by testing predefined hypotheses. Responsiveness and MCIC were measured with an anchor-based method. The area under the receiver Operating Characteristic Curve (AUC) and the optimal cut-off point were calculated. Smallest Detectable Change (SDC) was calculated to determine measurement error.RESULTS: In total, 1502 patients (age 18-65 years) with CLBP were included. For validity of the WAS and PDI-W, respectively, seven and six out of 10 hypotheses were not rejected. The WAS (n = 355) was responsive to change with an AUC of 0.70. MCIC was 1.5 point, SDCindividual 4.9, and SDCgroup 0.3. MCICs were 4.5, 1.5, and - 0.5 points for, respectively, low, middle, and high scoring baseline groups. The PDI-W (n = 297) was responsive to change with an AUC of 0.80. MCIC was - 2.5 points, SDCindividual 5.2, and SDCgroup 0.3. MCICs were - 0.5, - 2.5, and - 4.5 points for, respectively, low, middle, and high scoring baseline groups.CONCLUSION: Construct validity of the WAS and PDI-W was insufficient in this patient sample. The WAS and PDI-W are responsive to change. On average, improvements of 1.5 point (WAS) and - 2.5 points (PDI-W) were interpreted as clinically important. However, MCICs are also baseline dependent. Due to a risk of measurement error, at the individual level change scores should be interpreted with caution.
KW - Construct validity
KW - Responsiveness
KW - Minimal clinically important difference
KW - Smallest detectable change
KW - Longitudinal validity
KW - OUTCOME MEASURES
KW - HEALTH-STATUS
KW - SICK LEAVE
KW - ABSENCE
KW - IMPACT
KW - WOMEN
KW - RISK
U2 - 10.1007/s00586-022-07109-x
DO - 10.1007/s00586-022-07109-x
M3 - Article
C2 - 35066684
SN - 0940-6719
JO - European Spine Journal
JF - European Spine Journal
ER -