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

Said Sadiqi,Marcel W Post,S Rajasekaran,F Cumhur Oner,Klaus J Schnake,Lorin M Benneker,Jens R Chapman,Allard J Hosman,Frank Kandziora,Alexander R Vaccaro,Marcel F Dvorak

doi:10.1007/s00586-020-06554-w

Abstract

PurposeTo validate the Dutch version of AOSpine PROST (Patient Reported Outcome Spine Trauma).MethodsPatients 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.ResultsOut 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.ConclusionsVery 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.

Highlights

Measurement of the results of interventions on the individuals’ health-related quality of life is relevant for optimal treatment strategies and from the standpoint of cost-effectiveness
The outcomes of spine trauma patients have traditionally been limited to reporting of mortality and neurologic deficits or expressed with instruments designed for chronic conditions [1,2,3]
This study investigated the psychometric properties of the Dutch language version of the AOSpine PROST (Patient Reported Outcome Spine Trauma), a novel patient-reported outcome measure designed for spine trauma patients

Summary

Introduction

Measurement of the results of interventions on the individuals’ health-related quality of life is relevant for optimal treatment strategies and from the standpoint of cost-effectiveness. The use of different outcome measures, which were not designed for spine trauma, contributes to the ongoing controversies on the optimal treatment of this specific patient population [4, 5]. To address this void, the AOSpine Knowledge Forum Trauma initiated a project to develop and validate a disease-specific outcome measure for spine trauma patients: the Patient Reported Outcome Spine Trauma (AOSpine PROST). Three studies aimed to identify ICF categories relevant to measure outcomes of traumatic spinal column injuries from different perspectives: research, experts and patients. A definitive Dutch version to be validated was developed [8]

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