Abstract
Objective
To address the relative influence of psychological factors on variation in Patient-Reported
Outcomes Measurement Information System (PROMIS) Physical Function (PF) Computer Adaptive
Test (CAT) and Oswestry Low Back Pain Disability Index (ODI) scores.
Design
Cross-sectional.
Setting
We enrolled patients with low back pain, presenting to clinicians specializing in
the treatment of spine conditions in a large urban area.
Participants
New and return English-speaking patients (N=116).
Main Outcome Measures
The PF CAT and ODI.
Methods
Patients completed the Pain Catastrophizing Scale short form, Patient Health Questionnaire
short form (PHQ-2), Pain Self-Efficacy Questionnaire short form (PSEQ-2), PROMIS PF
CAT and ODI on a secure tablet.
Results
The 95% CI for the amount of variation in PROMIS PF CAT scores (95% CI, 0.06-0.31)
accounted for by psychological measures overlapped with the 95% CI for the amount
of variation in ODI scores (CI, 0.26-0.53). PROMIS PF CAT had a strong correlation
with ODI (r=−0.69; P<.001). Greater PROMIS PF CAT scores were independently associated with fewer symptoms
of depression (β=−1.6; 95% CI, −2.7 to −0.58; P=.003). Higher ODI scores were independently associated with more catastrophic thinking
(β=1.2; 95% CI, 0.60-1.88; P<.001) and less self-efficacy (β=−2.4; 95% CI, −3.2 to −1.5; P<.001). PSEQ-2 accounted for the largest proportion of variation in ODI. PHQ-2 accounted
for the largest proportion of variation in PROMIS PF CAT. Psychological measures explained
more variation in ODI (semipartial R2=0.48 for psychological measures; adjusted R2 full model=0.49) than in PROMIS PF CAT (semipartial R2=0.17 for psychological measures; adjusted R2 full model=0.31).
Conclusions
The ODI and PROMIS PF CAT are comparably sensitive to psychological factors in patients
with persistent lower back pain. Given that the PROMIS PF CAT is more efficient to
administer, clinicians might consider using PROMIS PF CAT when assessing physical
limitations in patients with persistent lower back pain.
Keywords
List of abbreviations:
CAT (Computer Adaptive Test), ODI (Oswestry Low Back Pain Disability Index), PCS (Pain Catastrophizing Scale), PF (physical function), PHQ (Patient Health Questionnaire), PROMIS (Patient-Reported Outcomes Measurement Information System), PSEQ (Pain Self-Efficacy Questionnaire), STarT (Subgroups for Targeted Treatment)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 03, 2020
Footnotes
Disclosures: D.R. has or may receive payment or benefits from Skeletal Dynamics, Wright Medical for elbow implants, Deputy Editor for Clinical Orthopaedics and Related Research, Universities and Hospitals, Lawyers outside the submitted work. M.Q. has or may receive payment or benefits from Edwards Lifesciences Corp, Medtronic, Amgen, GlaxoSmithKline, Merck, and PRA Health Sciences outside the submitted work. The other authors have nothing to disclose.
Identification
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© 2020 by the American Congress of Rehabilitation Medicine
