Estimating individual health-related quality of life changes in low back pain patients
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 rece...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-07093-3 |
| _version_ | 1797388563827916800 |
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| author | Ron D. Hays Steven P. Reise Patricia M. Herman |
| author_facet | Ron D. Hays Steven P. Reise Patricia M. Herman |
| author_sort | Ron D. Hays |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T22:42:38Z |
| format | Article |
| id | doaj.art-bd42190601944bd794e129ff38e2b6e2 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-08T22:42:38Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-bd42190601944bd794e129ff38e2b6e22023-12-17T12:04:14ZengBMCBMC Musculoskeletal Disorders1471-24742023-12-012411610.1186/s12891-023-07093-3Estimating individual health-related quality of life changes in low back pain patientsRon D. Hays0Steven P. Reise1Patricia M. Herman2Division of General Internal Medicine & Health Services Research, UCLA Department of MedicineDepartment of Psychology, UCLARAND CorporationAbstract 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.https://doi.org/10.1186/s12891-023-07093-3Individual changePatient-reported outcomesPROMIS®Estimation |
| spellingShingle | Ron D. Hays Steven P. Reise Patricia M. Herman Estimating individual health-related quality of life changes in low back pain patients BMC Musculoskeletal Disorders Individual change Patient-reported outcomes PROMIS® Estimation |
| title | Estimating individual health-related quality of life changes in low back pain patients |
| title_full | Estimating individual health-related quality of life changes in low back pain patients |
| title_fullStr | Estimating individual health-related quality of life changes in low back pain patients |
| title_full_unstemmed | Estimating individual health-related quality of life changes in low back pain patients |
| title_short | Estimating individual health-related quality of life changes in low back pain patients |
| title_sort | estimating individual health related quality of life changes in low back pain patients |
| topic | Individual change Patient-reported outcomes PROMIS® Estimation |
| url | https://doi.org/10.1186/s12891-023-07093-3 |
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