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110 A Novel 6-Item Outcome Instrument (VNI-6) for Assessing the Effectiveness of Cervical Surgery in Registry Eefforts
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110 A Novel 6-Item Outcome Instrument (VNI-6) for Assessing the Effectiveness of Cervical Surgery in Registry Eefforts
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110 A Novel 6-Item Outcome Instrument (VNI-6) for Assessing the Effectiveness of Cervical Surgery in Registry Eefforts
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Journal Article
110 A Novel 6-Item Outcome Instrument (VNI-6) for Assessing the Effectiveness of Cervical Surgery in Registry Eefforts
2013
Overview
INTRODUCTION:Validated patient reported outcomes (PROs) for spinal disorders may be too lengthy to feasibly apply to large scale registry efforts. We set out to determine which PROs and their items are most valid and responsive, and which domains have closest correlation (overlap). Our aim was to introduce a shorter, valid and responsive, and more feasible questionnaire for measuring effectiveness of cervical surgery.
METHODS:A total of 87 patients undergoing cervical surgery for cervical radiculopathy were enrolled into our prospective registry. Baseline and 1-yr PROs were assessed. In order to assess the validity of PROs, ROC analysis was performed. In order to assess the responsiveness, standardized response means (SRM) was calculated. Correlation between items was assessed via Spearman rank. For PROs and their items demonstrating high validity (AUC > 0.70), and for individual items with similar dimensions and high correlation, items with maximum validity (AUC) were included in the final questionnaire, Vanderbilt Neck Index (VNI-6).
RESULTS:NDI (AUC0.72; SRM diff0.97) and SF-12 PCS (AUC0.66;SRM diff0.63) were found to be the most valid and responsive outcome measures. For NDI, pain intensity, personal care, reading, sleep and recreation had the highest AUC. For SF-12 PCS, general health, less accomplishment and limitation due to pain and effect on usual work had the highest AUC. Three of these 9 most valid items were found to have significant correlation (r = 0.52, P < .0001). Thus, 6 out of 22-items (personal care, reading, recreation, general health, accomplishment due to pain, effect on usual work) comprised our modified PRO, VNI-6. VNI-6 (AUC0.78; SRM diff1.15) demonstrated better validity and responsiveness than NDI or SF-12 PCS and strongly correlated with ODI (r = 0.81;P < .0001) and SF-12 PCS (r = 0.80;P < .0001).
CONCLUSION:The 10-item NDI and 12-item SF-12 PCS were the most valid and responsive measures for assessing effectiveness of cervical surgery. However, a more valid, responsive and feasible PRO instrument, VNI-6, can be constructed using 6 items, which can be utilized in large scale registry efforts.
Publisher
Oxford University Press,Copyright by the Congress of Neurological Surgeons,Wolters Kluwer Health, Inc
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