Global Consensus From Clinicians Regarding Low Back Pain Outcome Indicators for Older Adults: Pairwise Wiki Survey Using Crowdsourcing

Abstract

BackgroundLow back pain (LBP) is one of the most debilitating conditions among older adults. Unfortunately, existing LBP outcome questionnaires are not adapted for specific circumstances related to old age, which may make these measures less than ideal for evaluating LBP in older adults.ObjectiveTo explore the necessity of developing age-specific outcome measures, crowdsourcing was conducted to solicit opinions from clinicians globally.MethodsClinicians around the world voted and/or prioritized various LBP outcome indicators for older adults on a pairwise wiki survey website. Seven seed outcome indicators were posted for voting while respondents were encouraged to suggest new indicators for others to vote/prioritize. The website was promoted on the social media of various health care professional organizations. An established algorithm calculated the mean scores of all ideas. A score >50 points means that the idea has >50% probability of beating another randomly presented indicator.ResultsWithin 42 days, 128 respondents from 6 continents cast 2466 votes and proposed 14 ideas. Indicators pertinent to improvements of physical functioning and age-related social functioning scored >50 while self-perceived reduction of LBP scored 32.ConclusionsThis is the first crowdsourcing study to address LBP outcome indicators for older adults. The study noted that age-specific outcome indicators should be integrated into future LBP outcome measures for older adults. Future research should solicit opinions from older patients with LBP to develop age-specific back pain outcome measures that suit clinicians and patients alike.

Developing clinical prediction models for nonrecovery in older patients seeking care for back pain: the back complaints in the elders prospective cohort study

“… 29 Nevertheless, various studies in patients with back pain exhibited that pain and physical functioning are the 2 most important outcomes, reasons to seek care, and part of a broad definition of recovery. 1 , 7 , 28 , 33 , 65 Therefore, the following outcome measures were used: the 11-point numeric rating scale (NRS, ranging from 0 “no pain” to 10 “worst pain ever”) 61 to measure pain intensity and the 24-item Roland Morris Disability Questionnaire (RMDQ, ranging from 0 “no disabilities” to 24 “maximal disability”) 45 to measure physical functioning. These 2 instruments also represent core outcome measures in patients with low back pain.…”

Development and Validation of a Comprehensive Well-Being Scale for People in the University Environment (Pitt Wellness Scale) Using a Crowdsourcing Approach: Cross-Sectional Study

“…Crowdsourcing has been used in many previous studies [37][38][39][40][41][42][43][44][45][62][63][64][65]; however, the role of study participants was mainly limited to providing responses to already existing questionnaires, instead of being involved in all stages of the questionnaire development and evaluation. In this study, guided by the user-centered approach, samples of the target population were involved in all stages of questionnaire development and…”

“…In recent years, crowdsourcing has been used to collect ideas from a crowd [36][37][38]. The benefit of crowdsourcing is that the collected wisdom of the crowd can be identified by using feedback obtained from a large pool of the target population [39][40][41][42][43][44][45]. On the other hand, most people in the crowd do not have formal training in research or scale development; therefore, the information from the crowd cannot be solely depended on to create a new scale.…”

The Italian version of the Quebec Back Pain Disability Scale: cross-cultural adaptation, reliability and validity in patients with chronic low back pain

“…With such a high epidemiological and clinical burden, it is of importance to apply evidence-based, validated and comprehensive outcome measures to help clinicians to monitor quality of care and effectiveness of interventions [4]. There is consensus among experts and patients that physical functioning (intended as the patient's ability to carry out physical daily activities) is the most important outcome domain to measure in patients with LBP [5,6] The most frequently recommended and used questionnaires to measure this domain are the Roland Morris Disability Questionnaire (RMDQ) and the Oswestry Disability Index (ODI) [7,8]. However, the former does not provide any questions asking specifically about lifting, carrying, pulling or pushing objects, and the latter does not have any questions pertaining to bending or body movement [9,10]; additionally, both RMDQ and ODI contain various items measuring domains other than physical functioning (e.g.…”