Psychometric properties of the Cervical Spine Outcomes Questionnaire and its relationship to standard assessment tools used in spine research.
BACKGROUND
The Cervical Spine Outcomes Questionnaire (CSOQ), a disease-specific outcomes instrument, has not been systematically compared with the Short Form-36 (SF-36) or the Neck Disability Index (NDI).


OBJECTIVE
To examine the psychometric properties of the CSOQ and to compare them with those of the SF-36 and NDI.


METHODS
Prospective analysis of outcomes data in patients undergoing surgery.


METHODS
We used telephone surveys (CSOQ) and clinical assessments (SF-36 and NDI) to evaluate 534 patients undergoing anterior cervical decompression and fusion at 23 nationwide sites. The psychometric properties of the CSOQ were analyzed for floor/ceiling effect, internal consistency of items within the CSOQ, and concurrent validity with the SF-36 and NDI.


RESULTS
The CSOQ domain scores showed good psychometric properties (Cronbach's alpha >0.70). Only physical symptoms (other than pain) showed a ceiling effect. The CSOQ domain scores had good concurrent validity (Spearman rank correlation coefficient >0.70) with the mental health score of the SF-36 and the total disability score of NDI.


CONCLUSIONS
The CSOQ domain scores provide a disease-specific assessment of functional limitations resulting from cervical spine disorders. The domain scores for functional disability and psychological distress provide similar information to that provided by the NDI and SF-36. The CSOQ domain scores for pain severity provide information that is more specific to cervical disc disease than does the physical health score of the SF-36.
Skolasky
Richard L
RL
Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA.
Riley
Lee H
LH
Albert
Todd J
TJ
D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical; D004185:Disability Evaluation; D006801:Humans; D010146:Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013122:Spinal Diseases / Q000150:complications / Q000523:psychology / Q000601:surgery; D013123:Spinal Fusion; D011795:Surveys and Questionnaires