Elsevier

The Spine Journal

Volume 13, Issue 11, November 2013, Pages 1667-1674
The Spine Journal

Research Article
Neck and back pain specific outcome assessment questionnaires in the Spanish language: a systematic literature review

https://doi.org/10.1016/j.spinee.2013.08.046Get rights and content

Abstract

Background context

Accurate measurement of functional improvement in clinical practice is becoming increasingly recognized as essential in demonstrating whether patients are deriving meaningful benefit from care. Several simple questionnaires have been developed for this purpose. The majority of these have been developed in English. In North America, there is a growing need for clinical tools, including outcome assessment tools that are available in the Spanish language.

Purpose

The purpose of this study was to systematically review the literature regarding spine-specific outcome assessment questionnaires that are available in Spanish and to examine the evidence on their clinical utility.

Study design

Systematic review.

Methods

The Medline, CINAHL, Embase, and MANTIS databases were searched for any studies on the topic of outcome assessment questionnaires in the Spanish language. Relevant articles were reviewed, and the data on reliability, validity, time to completion, and any other properties of the questionnaire was extracted.

Results

The search strategy identified 287 articles, of which 10 were deemed relevant. With regard to neck pain, data were found regarding Spanish translations of the Northwick Park Neck Pain Questionnaire, Neck Disability Index (NDI), and Core Outcome Measure for neck pain. With regard to low back pain, data were found regarding Spanish translations of the Oswestry Low Back Pain Disability Index (ODI), Roland Morris Disability Questionnaire (RMQ), and the North American Spine Society—American Academy of Orthopedic Surgeons questionnaire.

Conclusions

Several reliable and valid outcome assessment questionnaires are available in the Spanish language. All were originally developed in English. It appears from the data reviewed that the most useful instruments are the NDI for neck pain patients and the ODI and RMQ for low back pain patients. The current trend is for the development of culturally adapted versions of these questionnaires that are specific to a particular country or region.

Introduction

In the current health care climate in the United States and other nations, evidence-based practice, value (ie, outcome per dollar spent [1]) and accountability for outcomes and cost [2] are becoming increasingly emphasized. As a result, clinicians will be expected to produce credible data that demonstrate whether their patients are receiving meaningful benefit from care. Thus it is important for private practitioners and clinics to use reliable and valid outcome assessment tools. In the management of spine-related disorders, several clinical assessment procedures have been used over the years, including range of motion, muscle strength, and endurance capacity. However, recent studies have suggested that these parameters may not truly reflect patients' ability to perform the normal functions of daily life [3], [4]. Evidence suggests that a clearer picture of a patient's functional abilities, and thus the improvement or lack thereof in functional abilities as a result of intervention, can be obtained from simple questionnaires that inquire about the degree to which the spine problem is interfering with the patient's ability to perform various activities of daily living as well as the degree of distress the patient is feeling as a result of their particular spine problem [4]. Several spine-specific questionnaires have been developed for this purpose. Ideally, a good spine-specific outcome assessment questionnaire will be: (1) based on a credible conceptual model of spine pain; (2) brief; (3) suitable for use in a routine clinical setting; (4) acceptable to patients, clinicians and researchers; and (5) reliable, valid, and responsive to clinically meaningful change [5]. Therefore, for an instrument to be considered useful in research and clinical environments it is best if it meets most or all of these criteria.

In most cases, the spine-specific outcome assessment instruments that are currently available have been developed and validated in English-speaking environments. Spanish is the third most widely spoken language in the world after Mandarin and English [6]. The US Census Bureau expects Hispanics to make up nearly 25% of the US population by 2050 [7]. Therefore, it can be expected that the number of Spanish speaking patients seen in US health care facilities will grow rapidly over the next several years. Thus there is a growing need for spine practitioners in the United States to have available to them reliable and valid means of measuring the functional outcome of care using spine-specific instruments that are available in validated form in the Spanish language.

The purpose of this study is to review the literature to determine what spine-specific outcome assessment questionnaires are available in validated form in Spanish.

Section snippets

Methods

The following databases were searched up to 1 August 2011: Medline, CINAHL, Embase, and MANTIS. Searches of the authors' own libraries as well as the reference lists of retrieved articles were also conducted. Finally, citation searches of relevant articles and texts were conducted manually. The search terms that were used can be found in Table 1.

Studies were included if they were in English or Spanish and presented original data on the reliability, validity, psychometric properties, and/or

Results

The search strategy identified 287 articles, and of these, 10 were deemed relevant (Table 2). We have divided the presentation of the literature into those studies that apply to patients with neck pain (NP) and those that apply to patients with low back pain (LBP).

Discussion

There is a growing trend in health care toward demanding accountability for outcome of care (ie, in the near future, spine clinicians will be expected to demonstrate that the care they are providing is bringing meaningful benefit to their patients as well as value to the health care system). Thus, it has become increasingly important for spine clinicians to be able to accurately monitor and quantify functional improvement in response to treatment using tools that are applicable to a busy

Conclusion

Several spine pain–specific outcome assessment questionnaires have been translated into Spanish and evaluated for reliability, validity, and clinical usefulness. Based on this review of the available literature, it would appear that in NP patients the NDI is most useful and in LBP patients the ODI and RMQ are most useful. Further research is needed to develop tools that are specific to the country or region in which they are being used as well as to determine whether other outcome assessment

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    FDA device/drug status: Not applicable.

    Author disclosures: DRM: Support for travel to meetings for the study or other purposes: New York Chiropractic College (B); Endowments: MedRisk Inc (B). ML: Nothing to disclose.

    The disclosure key can be found on the Table of Contents and at www.TheSpineJournalOnline.com.

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