title: Development of a self-administered questionnaire to screen patients for cervical myelopathy.
abstract: BACKGROUND
  In primary care, it is often difficult to diagnose cervical myelopathy. However, a delay in treatment could cause irreversible aftereffects. With a brief and effective self-administered questionnaire for cervical myelopathy, cervical myelopathy may be screened more easily and oversight may be avoided. As there is presently no screening tool for cervical myelopathy, the aim of this study was to develop a self-administered questionnaire for the screening of cervical myelopathy.
  
  
  METHODS
  A case-control study was performed with the following two groups at our university hospital from February 2006 to September 2008. Sixty-two patients (48 men, 14 women) with cervical myelopathy who underwent operative treatment were included in the myelopathy group. In the control group, 49 patients (20 men, 29 women) with symptoms that could be distinguished from those of cervical myelopathy, such as numbness, pain in the upper extremities, and manual clumsiness, were included. The underlying conditions were diagnosed as carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, tarsal tunnel syndrome, diabetes mellitus neuropathy, cervical radiculopathy, and neuralgic amyotrophy. Twenty items for a questionnaire in this study were chosen from the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire, which is a new self-administered questionnaire, as an outcome measure for patients with cervical myelopathy. Data were analyzed by univariate analysis using the chi-square test and by multiple logistic regression analysis. According to the resulting odds ratio, β-coefficients, and p value, items were chosen and assigned a score.
  
  
  RESULTS
  Eight items were chosen by univariate and multiple logistic regression analyses and assigned a score. The Hosmer-Lemeshow statistic showed p = 0.805. The area under the receiver operation characteristic curve was 0.86. The developed questionnaire had a sensitivity of 93.5% and a specificity of 67.3%.
  
  
  CONCLUSIONS
  We successfully developed a simple self-administered questionnaire to screen for cervical myelopathy.
authors.affiliation: Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan. hkhk0105@yahoo.co.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Koji
authors.initials: K
authors.lastname: Otani
authors.forename: Miho
authors.initials: M
authors.lastname: Sekiguchi
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Sekiguchi
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Konno
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016730:Program Development; D012680:Sensitivity and Specificity; D013118:Spinal Cord Diseases / Q000175:diagnosis*; D011795:Surveys and Questionnaires