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01.01.2016 | Original Article

Core Outcome Measure Index for low back patients: do we miss anxiety and depression?

verfasst von: C. Cedraschi, M. Marty, D. S. Courvoisier, V. Foltz, G. Mahieu, C. Demoulin, A. Gierasimowicz Fontana, M. Norberg, P. de Goumoëns, S. Rozenberg, S. Genevay, Section Rachis de la Société Française de Rhumatologie

Erschienen in: European Spine Journal | Ausgabe 1/2016

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Abstract

Purpose

The Core Outcome Measure Index (COMI) is a multidimensional questionnaire that investigates five dimensions in low back pain (LBP) patients, but does not address the psychological dimension. As the biopsychosocial perspective is recognized as important to capture the entire clinical picture of these patients, this multicenter prospective cohort study was designed to investigate the psychometric properties of a modified version of the COMI (COMI_AD) which included 2 additional items, exploring anxiety and depression, respectively.

Methods

168 subacute or chronic LBP patients recruited in spine clinics completed a set of questionnaires before and after treatment (follow-up at 6 months). Construct validity was explored by comparing each item of the COMI_AD to validated full-length questionnaires. Thus two additional questionnaires were included to assess the construct validity of the anxiety and depression measures. The psychometric properties of the COMI and COMI_AD were then compared.

Results

The two new items showed good internal consistency, high correlations with the corresponding full-length questionnaires, no floor or ceiling effect and good reproducibility (test–retest agreement kappa 0.68 for anxiety, 0.62 for depression). The addition of the 2 items did not alter internal validity (Cronbach’s alpha = 0.88 and 0.87, respectively). The smallest detectable difference, the Minimal Clinically Important Improvement and the Patient Acceptable Symptom State were only minimally affected by the changes.

Conclusion

The questions exploring anxiety and depression have good intrinsic and psychometric capacities (i.e., no floor or ceiling effects and high correlations with full-length scales) and did not significantly modify the psychometrics of the original COMI questionnaire. The COMI_AD offers the possibility to include the psychological dimension in the multidimensional evaluation without significantly affecting questionnaire length.

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Titel: Core Outcome Measure Index for low back patients: do we miss anxiety and depression?
verfasst von: C. Cedraschi
M. Marty
D. S. Courvoisier
V. Foltz
G. Mahieu
C. Demoulin
A. Gierasimowicz Fontana
M. Norberg
P. de Goumoëns
S. Rozenberg
S. Genevay
Section Rachis de la Société Française de Rhumatologie
Publikationsdatum: 01.01.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 1/2016
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-3935-9

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