Abstract

Introduction. Outcome evaluation is an important aspect of the treatment of patients with degenerative lumbar disease. We evaluated the usefulness of the Core Outcome Measures Index (COMI) in assessing people affected by degenerative lumbar disease in daily clinical practice. Methods. We evaluated 221 patients who had completed preoperatively and 2 years after surgery VAS pain, Short Form-36 (SF-36), Oswestry Disability Index (ODI) and COMI. We calculated the change of scores and its sensitivity to change. The internal consistency of the COMI items and the correlation between the COMI scores and the scores of the other measurements were assessed. Results. Statistically significant differences were observed between the mean scores of the preoperative and 2 years questionnaires for nearly all measurements. COMI showed a good internal consistency, except for the preoperative pain subscale. The sensitivity to change was high for the total COMI and its pain and well-being subscales and moderate for the rest. The COMI demonstrated strong correlation with the other measurements. Conclusions. The COMI is a useful tool for assessing the patient-based outcome in the studied population. Given its simplicity, good correlation with the SF-36 and ODI and its good sensitivity to change, it could replace more cumbersome instruments in daily clinical practice.

Highlights

  • Outcome evaluation is an important aspect of the treatment of patients with degenerative lumbar disease

  • In the United States, the lifetime prevalence of low back pain has been reported to be as high as 84% and the prevalence of chronic low back pain (CLBP) to be about 23%, with 11-12% of the population being disabled by low back pain [2]

  • The Core Outcome Measures Index (COMI) was validated against well-validated instruments such as the Roland-Morris or the Oswestry Disability Index (ODI) for back specific function and the Medical Outcomes Study Short Form-36 (SF-36), its Short Form Social function (SF)-12, or the EuroQol for general health status

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Summary

Introduction

Outcome evaluation is an important aspect of the treatment of patients with degenerative lumbar disease. We evaluated the usefulness of the Core Outcome Measures Index (COMI) in assessing people affected by degenerative lumbar disease in daily clinical practice. The authors designed a prospective study that aimed to evaluate the reliability, validity, and responsiveness of this instrument They evaluated this instrument in patients with subacute osteoporotic fracture (quick improvement of the pain after treatment) and chronic low back pain (slow improvement of the pain) and related the COMI scores to the scores of the Spanish-validated ODI, SF-36, and SF-12.

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