Abstract
PurposeThere is a wide selection of instruments and questionnaires available, but many are time consuming in their administration, for patients, practitioners and researchers alike. The Core Outcome Measures Index (COMI) is a short, self-administrated, multidimensional instrument translated into several languages that covers five domains recommended in the assessment of outcome in patients with low-back pain. The purpose of this study was to cross-culturally adapt the COMI from English to Swedish and to test the face and construct validity and reproducibility of its results in patients with low-back pain.MethodsParticipants (n = 102) were included from primary and secondary care. The participants reported moderate pain and disability levels. All participants filled in the COMI, the Oswestry Disability Index and the EQ5D at baseline. Forty-nine filled in the COMI again after 7 days for the reproducibility part of the study.ResultsThe instrument was successfully forward and back-translated. In the validation process, there were low floor/ceiling effects, with the exception of the symptom-specific well-being (floor) and work disability (ceiling) items. The specific COMI domains and whole score correlated significantly with the chosen reference scale scores to the hypothesised extent (Rho 0.30–0.60 and > 0.60 respectively). COMI reached ICC 0.63 (95% CI 0.42–0.77) in the reproducibility test and the separate items, ICC 0.41–0.78.ConclusionsThe Swedish COMI shows acceptable psychometric properties and is thus suitable to use as a short instrument for measuring important domains in patients with low-back pain. A future study should investigate the instrument's sensitivity to measure change after treatment.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
Highlights
Low-back pain (LBP) still is the number one disorder worldwide for years lived with disability [1]
Core Outcome Measurement Index (COMI) was successfully forward- and backtranslated into Swedish with neither semantic nor language ambiguities, and all items were approved by the expert group
All predefined hypotheses regarding the relationship between the scores for the specific COMI domains and the scores for the reference instruments were positively confirmed, with moderate to high correlations (Table 2)
Summary
Low-back pain (LBP) still is the number one disorder worldwide for years lived with disability [1]. In 1996, a multinational group of back pain researchers called for the use of standardised and administered outcome measures in patients with LBP [3]. They recommended assessment of the most important domains including pain, function, generic health status/well-being, disability and patient satisfaction. Items covering these domains were extracted from widely used PROMs resulting in a new core set of six items [3]. The initial core set showed satisfactory reliability and validity [4, 5], and was further developed with the addition of a seventh item to cover general quality of life, resulting in the Core Outcome Measurement Index (COMI), a self-administrated and multidimensional PROM [6]
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