title: Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ): part 4. Establishment of equations for severity scores. Subcommittee on low back pain and cervical myelopathy, evaluation of the clinical outcome committee of the Japanese Orthopaedic Association.
abstract: BACKGROUND
  To establish a patient-oriented outcome measure for cervical myelopathy, a subcommittee of the Japanese Orthopaedic Association (JOA) developed a new scoring system to evaluate the overall clinical status of patients, which could be completed by patients themselves. The subcommittee completed three large-scale studies to select and modify questions derived from various preexisting outcome measures including Short Form-36, and then finalized and validated the questionnaire, which comprised 24 questions.
  
  
  METHODS
  The finalized questionnaire was administered to 369 patients with cervical myelopathy due to disc herniation, spondylosis, or ossification of posterior longitudinal ligament by randomly selected board-certified spine surgeons. Patients with different severities of myelopathy were included to insure accuracy and responsiveness of this questionnaire against patients' different neurological status.
  
  
  RESULTS
  Data of 236 patients were employed and were subjected to rigorous statistical analyses. There was no question that was difficult to answer and distribution of answers for each question was not concentrated to one choice, indicating the appropriateness of all 24 questions. Results of factor analysis suggested that the 24 questions could be divided into five different factors or functional domains. The factors were defined as follows: factor 1, lower extremity function; factor 2, quality of life; factor 3, cervical spine function; factor 4, bladder function; and factor 5, upper extremity function. Finally, equations that would yield scores for the five factors were assembled. The score to be used to represent the degree of patients' disability or status in each domain can be calculated by multiplying prefixed numbers of selected answers to questions by preassigned coefficients. Coefficients were defined to make the minimum score 0 and the maximum score 100.
  
  
  CONCLUSIONS
  We have successfully established a questionnaire that is able to demonstrate the status of patients suffering cervical myelopathy from five different aspects represented by five intuitive numerical scores. The final issue to be confirmed is the responsiveness of this questionnaire to changes in patients' status after various surgical and nonsurgical treatments.
authors.affiliation: Laboratory of Statistics, Osaka City University Faculty of Medicine, Osaka, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Fukui
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Chiba
authors.forename: Mamoru
authors.initials: M
authors.lastname: Kawakami
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Konno
authors.forename: Masabumi
authors.initials: M
authors.lastname: Miyamoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Seichi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Shimamura
authors.forename: Osamu
authors.initials: O
authors.lastname: Shirado
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Taguchi
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
authors.forename: Katsushi
authors.initials: K
authors.lastname: Takeshita
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Tani
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Toyama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yonenobu
authors.forename: Eiji
authors.initials: E
authors.lastname: Wada
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanaka
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hirota
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002574:Cervical Vertebrae; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013118:Spinal Cord Diseases / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D011795:Surveys and Questionnaires