Reliability, validity and responsiveness of the Dutch version of the AOSpine PROST (Patient Reported Outcome Spine Trauma)

Abstract

Purpose To validate the Dutch version of AOSpine PROST (Patient Reported Outcome Spine Trauma). Methods Patients were recruited from two level-1 trauma centers from the Netherlands. Next to the AOSpine PROST, patients also filled out SF-36 for concurrent validity. Descriptive statistics were used to analyze the characteristics. Content validity was assessed by evaluating the number of inapplicable or missing questions. Also floor and ceiling effects were analyzed. Internal consistency was assessed by calculating Cronbach's α and item-total correlation coefficients (itcc). Spearman correlation tests were performed within AOSpine PROST items and in correlation with SF-36. Test-retest reliability was analyzed using Intraclass Correlation Coefficients (ICC). Responsiveness was assessed by calculating effect sizes (ES) and standardized response mean (SRM). Factor analysis was performed to explore any dimensions within AOSpine PROST. Results Out of 179 enrolled patients, 163 (91.1%) were included. Good results were obtained for content validity. No floor or ceiling effects were seen. Internal consistency was excellent (Cronbach's α = 0.96, itcc 0.50-0.86), with also good Spearman correlations (0.25-0.79). Compared to SF-36, the strongest correlation was seen for physical functioning (0.79; p < .001). Also test-retest reliability was excellent (ICC = 0.92). Concerning responsiveness analysis, very good results were seen with ES = 1.81 and SRM = 2.03 (p < 0.001). Factor analysis revealed two possible dimensions (Eigenvalues > 1), explaining 65.4% of variance. Conclusions Very satisfactory results were obtained for reliability, validity and responsiveness of the Dutch version of AOSpine PROST. Treating surgeons are encouraged to use this novel and validated tool in clinical setting and research to contribute to evidence-based and patient-centered care.

Long-Term Reliability and Validity of the AO Spine PROST (Patient-Reported Outcome Spine Trauma)

“…Also moderate to excellent test-retest reliability was obtained for all individual items. This is in agreement with findings from Sadiqi et al 8,9 in the previous psychometric studies for the AO Spine PROST with a follow-up up to 12 months.…”

“…Also using the EQ-5D-5L is more informative, since the validity of the AO Spine PROST was already tested in correlation to the SF-36 in previous validation studies. 8,9 In the current study good concurrent validity for the AO Spine PROST was found in comparison to the EQ-5D-5L (r = 0.76; P < 0.001), while slightly lower Copyright r 2022 Wolters Kluwer Health, Inc. All rights reserved.…”

“…Subsequently, patients had to master the Dutch language and not have cognitive impairments. In accordance with previous validation studies of the AO Spine PROST, patients with ASIA Impairment Scale (AIS) grade C, D, and E were included 8,9. Patients with AIS grade A and B were excluded as the AO Spine PROST was specifically designed to measure HRQoL in patients with AIS grade C, D, and E 8,9.…”

“…In accordance with previous validation studies of the AO Spine PROST, patients with ASIA Impairment Scale (AIS) grade C, D, and E were included. 8,9 Patients with AIS grade A and B were excluded as the AO Spine PROST was specifically designed to measure HRQoL in patients with AIS grade C, D, and E. 8,9 Patients suffering polytrauma (injury severity score > 15) were excluded due to the different cause influencing HRQoL.…”

“…This tool is developed specifically to measure the function and health status in patients after their spine trauma. Previous validation studies on the Dutch and English language versions of the AO Spine PROST had a follow-up until 12 months 8,9…”