Cross-cultural adaptation and validation of the Slovenian version of the Core outcome measures index for low back pain

David Vozlič,Anne Frances Mannion,Rok Vengust,Miha Vodičar,Matevž Topolovec,Nejc Plohl

doi:10.1186/s12891-020-03280-8

Abstract

BackgroundTo conduct a cross-cultural adaptation and validation of the Core Outcome Measures Index (COMI) in the Slovenian language, for use in patients with low back pain.MethodsThe English version of COMI was translated into Slovene following established guidelines. Three hundred fifty-three patients with chronic low back pain were recruited from the Orthopedic clinic department of a tertiary care teaching institution. Data quality, construct validity, responsiveness, and test-retest reliability of the COMI were assessed.ResultsThe questionnaire was generally well accepted with no missing values. The majority of items exhibited only mild ceiling effects (below 20.0%) and somewhat more prominent floor effects, which were similar to previous studies (4.5–78.8%). Correlations with Oswestry Disability Index (ODI) were high (ρ = 0.76 between overall COMI and ODI scores), suggesting that the Slovene version of COMI had high construct validity. Additionally, the Slovene version of COMI successfully captured surgical patients’ improvement in their low back problem after surgery (overall COMI score change: Z = − 9.34, p < .001, r = − 0.53) and showed acceptable test-retest reliability (ICC = 0.86).ConclusionsThe Slovene version of COMI showed good psychometric properties, comparable to those of previously tested language versions. It represents a valuable instrument for the use in future domestic and multicenter clinical studies.

Highlights

To conduct a cross-cultural adaptation and validation of the Core Outcome Measures Index (COMI) in the Slovenian language, for use in patients with low back pain
We aimed to find out whether the median change in the overall COMI score differed between patients who perceived the therapeutic intervention as being helpful or very helpful and those who perceived it as less efficacious [8, 9]
Score distribution, missing data According to the Kolmogorov-Smirnov test, all of the individual COMI items, as well as the overall COMI score, violated the normality assumption

Summary

Introduction

To conduct a cross-cultural adaptation and validation of the Core Outcome Measures Index (COMI) in the Slovenian language, for use in patients with low back pain. Various low back disability scales have been proposed, including Short Form (SF)-36 [2], Quebec Back Pain Disability Scale [3], Oswestry Disability Index [4, 5] and others These questionnaires are limited by their only assessing one domain. The Core Outcome Measures Index (COMI) [8, 9] is a brief, multidimensional instrument that has proven to be reliable, valid and highly responsive [9, 10] and has become the main tool for the Spine Tango registry of EUROSPINE [11] It can be reliably used in clinical and research settings [6, 7]. It has been cross-culturally adapted and validated for use in Topolovec et al BMC Musculoskeletal Disorders (2020) 21:232 many different languages (https://www.eurospine.org/ forms.htm)

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