An outcome measure for patients with cervical myelopathy: Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ): Part 1.
BACKGROUND
An outcome measure to evaluate the neurological function of cervical myelopathy was proposed by the Japanese Orthopaedic Association in 1975 (JOA score), and has been widely used in Japan. However, the JOA score does not include patients' satisfaction, disability, handicaps, or general health, which can be affected by cervical myelopathy. The purpose of this study was to develop a new outcome measure for patients with cervical myelopathy.


METHODS
This study was conducted in eight university hospitals and their affiliated hospitals from February to May 2002. The questionnaire included 77 items. Forty-one questions, which were originally listed by the authors, were for evaluation of the physical function of the cervical spine and spinal cord. The Medical Outcome Study Short-Form 36-Item Health Survey (SF-36) was used to examine health-related quality of life (QOL). Patients with cervical myelopathy and healthy volunteers were recruited at each institution. After analysis of the answers from patients and volunteers, irrelevant questions using the following criteria were excluded: (1) a question 80% of answers for which were concentrated on one choice, (2) a question whose answer was highly correlated with that of other questions, (3) a question that could be explained by other questions, and (4) a question for which the distribution of the answers obtained from the patients was not different from that obtained from the normal volunteers.


RESULTS
The patients comprised 164 men and 86 women, and the healthy volunteers 96 men and 120 women. Thirteen items from the questions about the physical functions of the cervical spine and the spinal cord and 11 items from SF-36 remained as candidates that should be included in the final outcome measure questionnaire.


CONCLUSIONS
Twenty-four questions remained as candidates for the final questionnaire. This new self-administered questionnaire might be used to evaluate the outcomes in patients with cervical myelopathy more efficiently.
Fukui
Mitsuru
M
Laboratory of Statistics, Osaka City University Faculty of Medicine, Osaka, Japan.
Chiba
Kazuhiro
K
Kawakami
Mamoru
M
Kikuchi
Shin-Ichi
S
Konno
Shin-Ichi
S
Miyamoto
Masabumi
M
Seichi
Atsushi
A
Shimamura
Tadashi
T
Shirado
Osamu
O
Taguchi
Toshihiko
T
Takahashi
Kazuhisa
K
Takeshita
Katsushi
K
Tani
Toshikazu
T
Toyama
Yoshiaki
Y
Wada
Eiji
E
Yonenobu
Kazuo
K
Tanaka
Takashi
T
Hirota
Yoshio
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D017063:Outcome Assessment, Health Care / Q000379:methods*; D015995:Prevalence; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012955:Societies, Medical; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires / Q000592:standards*