Lumbar Computerized Adaptive Test and Modified Oswestry Low Back Pain Disability Questionnaire: Relative Validity and Important Change

Hart, Dennis L.; Stratford, Paul W.; Werneke, Mark W.; Deutscher, Daniel; Wang, Ying-Chih

doi:10.2519/jospt.2012.3942

Cited by 25 publications

(7 citation statements)

References 72 publications

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“…these results are similar to those from Rasch analysis of the RMDQ-24 (16)(17)(18)(19), which have also shown that version of the questionnaire to contain some misfitting items and to have poor targeting of items with high and low activity limitation. therefore, in our view it is timely to reconsider whether: (i) the RMDQ should be reconstructed using an instrument development approach based on item-response theory, including the consideration of different items and response options; or (ii) the use of alternative questionnaires should be recommended, such as the Oswestry Disability Index, that have shown evidence of fitting the Rasch model (33); or (iii) a completely new questionnaire should be developed, perhaps utilizing a computer adaptive testing delivery platform (34).…”

Section: Discussionmentioning

confidence: 99%

Rasch analysis of the 23-item version of the Roland Morris Disability Questionnaire

Grotle¹,

Dunn²,

Albert³

et al. 2015

J Rehabil Med

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As similar results have been found for the RMDQ-24, we believe it is timely to reconsider whether: (i) the RMDQ should be reconstructed using an item-response theory-based approach that includes consideration of new items and response options; or (ii) the use of alternative questionnaires should be recommended, such as the Oswestry Disability Index, that have shown evidence of fitting the Rasch model; or (iii) a completely new condition-specific questionnaire should be developed, perhaps utilizing a computerized adaptive testing platform.

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Section: Discussionmentioning

confidence: 99%

Rasch analysis of the 23-item version of the Roland Morris Disability Questionnaire

Grotle¹,

Dunn²,

Albert³

et al. 2015

J Rehabil Med

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“…32 Using item response theory and computerized adaptive tests to collect outcomes data in routine clinical work is a relatively new concept, but small-and large-scale applications have been described. 10,28,31,37,41 The FS measures estimated by the LCAT were supported for adequate internal consistency reliability (α = .92) 32 ; construct validity 32,37 ; predictive validity 34 ; sensitivity to change 33,37 ; responsiveness 33,37 ; interpretability using levels of minimal detectable change (MDC), minimal clinically important improvement (MCII), and a functional staging model 62 ; and usability. 13,63 The LCAT FS measures are based on a rating-scale item response theory model appropriate for regression techniques that assumes linearity of continuous data.…”

Section: Data Collectionmentioning

confidence: 92%

Physical Therapists' Level of McKenzie Education, Functional Outcomes, and Utilization in Patients With Low Back Pain

Deutscher

Werneke

Gottlieb³

et al. 2014

J Orthop Sports Phys Ther

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There was a slightly greater improvement of 0.7 to 1.3 points in FS at discharge in patients receiving physical therapy for low back pain by physical therapists who underwent McKenzie training. This difference was clinically important for an additional 5% of patients who achieved the minimal clinically important improvement when treated by therapists with some McKenzie training. Reduction in physical therapy utilization was 0.6 to 0.9 visits, with the fewest visits utilized by patients of physical therapists at the McKenzie Part D and credentialed levels. Together, these findings suggest improved cost-effectiveness at advanced McKenzie training levels. Ways to improve ongoing education and patient outcomes were proposed.

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“…The functional status (FS) outcome measure, developed and used by FOTO, is body region specific, with demonstrated validity and reliability for common musculoskeletal conditions. 11,[15][16][17][18][19][20] Patients enter demographic information into the system and complete a baseline FS measure electronically prior to their evaluation and intervention. At subsequent visits, the therapist and/or administrative staff issue follow-up surveys, including the final discharge FS survey that includes patient satisfaction questions.…”

Section: Description Of Data Sourcementioning

confidence: 99%

Implications of Practice Setting on Clinical Outcomes and Efficiency of Care in the Delivery of Physical Therapy Services

Childs¹,

Harman²,

Rodeghero³

et al. 2014

J Orthop Sports Phys Ther

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1 Health care costs currently consume 17% of gross domestic product in the United States and continue to increase.26 Musculoskeletal conditions represent a substantial burden to the health care system in terms of disability and direct and indirect costs, with the majority of expenditures directed toward high-cost procedures such as surgery, imaging, and prescription medication. 4,10 Many patients with musculoskeletal conditions benefit from care provided by physical therapists, and there is evidence to suggest that early physical therapy intervention adherent to practice guidelines may result in lower subsequent health care utilization, particularly invasive and costly procedures such as pharmaceuticals, injections, and surgery. 8,9 Physical therapists provide services in a variety of settings, with approximately 34% of physical therapists in the United States employed in the private practice setting and 21% in a health system or hospital outpatient setting.6 Health services research can inform optimal care delivery models by exploring differences in clinical outcomes and costs of care in the most common practice settings in which physical therapy services are typically delivered. According to Donabedian's 7 structure-process-outcome model to assess quality of care, differences in the structure, such as those between hospitalbased and private practice settings, would likely lead to differences in the process of physical therapy care delivered to patients, which could subsequently affect outcomes of care. The practice settings and cost structures in which physical therapists practice vary widely; hence, T T STUDY DESIGN: Retrospective analysis of episodes of care. T T OBJECTIVE:To assess the implications of practice setting (hospital outpatient settings versus private practice) on clinical outcomes and efficiency of care in the delivery of physical therapy services. T T BACKGROUND:Many patients with musculoskeletal conditions benefit from care provided by physical therapists. The majority of physical therapists deliver services in either a private practice setting or in a hospital outpatient setting. There have not been any recent studies comparing whether clinical outcomes or efficiency of care differ based on practice setting. T T METHODS: Practices that use the Focus OnTherapeutic Outcomes, Inc system were surveyed to determine the specific type of setting in which outcomes were collected in patients with musculoskeletal impairments. Patient outcome data over 12 months (2011)(2012) were extracted from the database and analyzed to identify differences in the functional status achieved and the efficiency of the care delivery process between private practices and hospital outpatient settings. T T RESULTS:The data suggest that patients experience more efficient care when receiving physical therapy in hospital outpatient settings compared to private practice settings, as demonstrated by 3.1 points of greater improvement in functional status over 2.9 fewer physical therapy visits. However, the difference in improvem...

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Lumbar Computerized Adaptive Test and Modified Oswestry Low Back Pain Disability Questionnaire: Relative Validity and Important Change

Cited by 25 publications

References 72 publications

Rasch analysis of the 23-item version of the Roland Morris Disability Questionnaire

Rasch analysis of the 23-item version of the Roland Morris Disability Questionnaire

Physical Therapists' Level of McKenzie Education, Functional Outcomes, and Utilization in Patients With Low Back Pain

Implications of Practice Setting on Clinical Outcomes and Efficiency of Care in the Delivery of Physical Therapy Services

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