Abstract
PurposeThe aim was to determine the responsiveness and minimal important change (MIC) of the questionnaire ProFitMap-neck that measures symptoms and functional limitations in women with neck pain. The same measurement properties were determined for Neck Disability Index (NDI) for comparison purposes.MethodsLongitudinal data were derived from two randomized controlled trials, including 103 and 120 women with non-specific neck pain, with questionnaire measurements performed before and after interventions. Sensitivity and specificity to discriminate between improved and not or little changed participants, based on categorization of a global rating of change scale (GRCS), were determined for the ProFitMap-neck indices and NDI by using area under receiver operating characteristic curves (AUC). Correlations between the GRCS anchor and change scores of the questionnaires were also used to assess responsiveness. The change score that showed the highest combination of sensitivity and specificity was set for MIC.ResultsThe ProFitMap-neck indices showed similar responsiveness as NDI with AUC exceeding 0.70 (Range: ProFitMap-neck, 0.74–0.83; NDI, 0.75–0.86). The MIC in the two samples ranged between 6.6 and 13.6 % for ProFitMap-neck indices and 5.2 and 6.3 % for NDI. Both questionnaires had significant correlations with GRCS (Spearman’s rho 0.47–0.72).ConclusionsValidity of change scores was endorsed for the ProFitMap-neck indices and NDI with adequate ability to discriminate between improved and not or little changed participants. Values of minimal important change were presented.
Highlights
Neck pain is highly prevalent with a reported 1-year prevalence estimated to be 30 to 50 % in the general population [1]
The maximum possible score was reached at follow-up for five and six participants for the ProFitMap-neck function index and Neck Disability Index (NDI), respectively
Distribution-based methods are conceptually different in being based on statistical characteristics of the sample distribution. These methods rather deal with minimal detectable change than any indication of the importance for the patient of the observed change, which is the ground for anchor-based methods [48, 57, 58]
Summary
Neck pain is highly prevalent with a reported 1-year prevalence estimated to be 30 to 50 % in the general population [1]. Neck pain contributes to activity limitations in 11 to 14 % of workers [2]. The alleviation of symptoms and restoration of functional limitations are important for neck pain sufferers without a clear pathophysiology. To evaluate and establish effective treatment and rehabilitation strategies, access to reliable and valid patient-reported outcome measures, i.e., standardized questionnaires measuring specific constructs of interest, is a necessity. Weaknesses in measurement properties of several questionnaires were recently recognised, and important methodological aspects to improve were, for example, content validity regarding the relevance and comprehensiveness of items and the use of better statistical methods in responsiveness studies [5, 6]. Wiitavaara and co-workers [7] found a low
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