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Estimating individual health-related quality of life changes in low back pain patients.

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  • Author(s): Hays RD;Hays RD; Reise SP; Reise SP; Herman PM; Herman PM
  • Source:
    BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2023 Dec 11; Vol. 24 (1), pp. 961. Date of Electronic Publication: 2023 Dec 11.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968565 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2474 (Electronic) Linking ISSN: 14712474 NLM ISO Abbreviation: BMC Musculoskelet Disord Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2000-
    • Subject Terms:
      Quality of Life* ; Low Back Pain*/diagnosis ; Low Back Pain*/therapy; Adult ; Humans ; Male ; Female ; Reproducibility of Results ; Retrospective Studies ; Fatigue ; Patient Reported Outcome Measures
    • Abstract:
      Background: There is a need to evaluate different options for estimating individual change in health-related quality of life for patients with low back pain.
      Methods: Secondary analysis of data collected at baseline and 6 weeks later in a randomized trial of 749 adults with low back pain receiving usual medical care (UMC) or UMC plus chiropractic care at a small hospital at a military training site or two large military medical centers. The mean age was 31; 76% were male and 67% were White. The study participants completed the Patient-Reported Outcomes Measurement Information System (PROMIS®)-29 v 1.0 physical function, pain interference, pain intensity, fatigue, sleep disturbance, depression, anxiety, satisfaction with participation in social roles, physical summary, and mental health summary scores (T-scored with mean = 50 and standard deviation (SD) = 10 in the U.S. general population).
      Results: Reliability estimates at the baseline ranged from 0.700 to 0.969. Six-week test-retest intraclass correlation estimates were substantially lower than these estimates: the median test-retest intraclass correlation for the two-way mixed-effects model was 0. 532. Restricting the test-retest reliability estimates to the subset who reported they were about the same as at baseline on a retrospective rating of change item increased the median test-retest reliability to 0.686. The amount of individual change that was statistically significant varied by how reliability was estimated, and which SD was used. The smallest change needed was found when internal consistency reliability and the SD at baseline were used. When these values were used, the amount of change needed to be statistically significant (p < .05) at the individual level ranged from 3.33 (mental health summary scale) to 12.30 (pain intensity item) T-score points.
      Conclusions: We recommend that in research studies estimates of the magnitude of individual change needed for statistical significance be provided for multiple reliability and standard deviation estimates. Whenever possible, patients should be classified based on whether they 1) improved significantly and perceived they got better, 2) improved significantly but did not perceive they were better, 3) did not improve significantly but felt they got better, or 4) did not improve significantly or report getting better.
      (© 2023. The Author(s).)
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    • Grant Information:
      R01 AT010402 United States AT NCCIH NIH HHS; 1R01AT010402-01A1 United States AT NCCIH NIH HHS
    • Contributed Indexing:
      Keywords: Estimation; Individual change; PROMIS®; Patient-reported outcomes
    • Publication Date:
      Date Created: 20231212 Date Completed: 20231216 Latest Revision: 20240210
    • Publication Date:
      20250114
    • Accession Number:
      PMC10712133
    • Accession Number:
      10.1186/s12891-023-07093-3
    • Accession Number:
      38082389