Assessment by proxy of the SF-36 and WHO-DAS 2.0. A systematic review.

BACKGROUND AND OBJECTIVE: In some cases, for the evaluation of the health status of patients it is not possible to obtain data directly from the patient. The objective of this study was to determine if the instruments that cannot be applied to the patient can be completed by a proxy. METHODS: A systematic review of the literature was carried out and 20 studies were included. The instruments reviewed in this synthesis were: Short Form-36 (SF-36), Montreal Cognitive Assessment (MoCA), WHODAS 2.0, Patient Health Questionnaire 9 (PHQ-9), State-Trait Anxiety Inventory (STAI), Disability Rating Scale (DRS). RESULTS: The levels of agreement between the responses of the patients and the proxies were good, mainly when evaluating HRQoL and functioning with the SF-36 and WHODAS 2.0 instruments, respectively, with a higher level of agreement in the more objective and observable domains such as physical functioning and lower level of agreement in less objective domains, such as emotional or affective status, and self-perception. CONCLUSION: In patients who cannot complete the different instruments, the use of a proxy can help avoid the omission of responses.

Validation of the Roland Morris Questionnaire in Colombia to Evaluate Disability in Low Back Pain.

STUDY DESIGN: An observational study was performed to validate a scale. OBJECTIVE: This study validated the Roland Morris Questionnaire (RMQ) in Colombia. SUMMARY OF BACKGROUND DATA: The RMQ is a frequently used instrument for the evaluation of disability in patients with low back pain. The psychometric properties of the RMQ are highly reliable, but a validated version is not available in our country. METHODS: The RMQ 24-item scale ranges from 0 (no disability) to 24 (maximum disability) and it was applied to 133 patients older than 18 years of age with low back pain of any etiology and duration. Reliability, validity of content, construct and criterion were evaluated, and the latter was compared with the Oswestry Disability Index 2.1a, SF-36, and the visual analogue scale. Sensitivity to change was evaluated in patients with subacute low back pain, and a pharmacological and/or physical rehabilitation intervention was performed and the effect size of the treatment was calculated with Cohen's d coefficient. RESULTS: The patients' average age was 43.4 (16.3) years, out of which 67.7% were females. Internal consistency revealed a coefficient of Cronbach's alpha of 0.86. Intraobserver reliability revealed an intraclass correlation coefficient of 0.92. Construct validity between acute and chronic patients showed no significant differences (P = 0.405). Concurrent criterion validity compared with the Oswestry Disability Index 2.1a revealed a Pearson correlation coefficient of 0.745 which is a very good correlation. The correlation between RMQ and SF-36 was significant. The Pearson correlation between the RMQ and visual analogue scale was r = 0.438 with a P < 0.005. Sensitivity to change had a Cohen's d coefficient of 1.27, which corresponds to a very large effect size. CONCLUSION: The RMQ is a useful and reliable instrument for the evaluation of patients with low back pain, and it allows an adequate clinical postintervention follow-up. LEVEL OF EVIDENCE: 3.

Validation in Colombia of the Oswestry disability questionnaire in patients with low back pain.

STUDY DESIGN: Observational study to validate a scale. OBJECTIVE: To translate, culturally adapt, and validate the Oswestry Disability Index (ODI), version 2.1a. SUMMARY OF BACKGROUND DATA: The ODI is one of the most frequently used tools to evaluate disability in patients with low back pain. Its psychometric properties have shown to be highly reliable. Currently, no validated Colombian version is available. METHODS: The ODI (2.1a) was translated into Spanish and this translated version was analyzed in terms of semantic and linguistic equivalence. Then, the Spanish version was translated back into English. The first time, the ODI was administered to a total of 111 patients with back pain. Internal consistency, construct validity, content validity and criterion validity were evaluated for the scale. The inter-rater reliability was evaluated by 2 different observers a day apart from each other and the intra-rater reliability was determined by the same observer, 7 days apart. A sensitivity-to-change analysis was performed on 81 patients. RESULTS: Of the sample, 67.6% were women, with a mean (SD) age of 44.88 (16.38) years. Cronbach alpha coefficient was 0.86. Inter-rater reliability yielded an intraclass correlation coefficient (ICC) of 0.94 whereas intrarater reliability yielded an ICC of 0.95. Pearson correlation between ODI and each of the 8 domains of SF-36, was statistically significant. Construct validity, when comparing extremely acute and chronic groups, did not show any differences (P = 0.409). Concurrent criterion validity between ODI and Roland-Morris Disability Questionnaire (RMQ) was r = 0.75; between ODI and the Visual Analog Scale (VAS) was r = 0.540. For patients who received an intervention, the value of this change was 1.2. CONCLUSION: ODI-C is a helpful, reliable and valid tool in Colombia for back pain patient follow-up and assessment, regardless the stage of the evolution. It is an observational study to validate the Oswestry disability index (ODI) in the Spanish language. ODI is the most used tool in evaluating disability related to low back pain. The psychometric properties were evaluated in Colombia and the results were very good, similar to other studies.