title: McMaster-Toronto Arthritis Patient Preference Disability Questionnaire sensitivity to change in low back pain: influence of shifts in priorities.
abstract: OBJECTIVE
  To assess the sensitivity to change of the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR) in chronic low back pain (CLBP) and shifts in patients' priorities of disabling activities over time.
  
  
  METHODS
  A prospective longitudinal survey of 100 patients (38 males) with CLBP in a tertiary care teaching hospital. Evaluation at baseline and 6 months by the MACTAR, Quebec Back Pain Disability Questionnaire (QUEBEC), Hospital Anxiety and Depression scale (HAD), Fear-Avoidance Beliefs Questionnaire (FABQ), Coping Strategies Questionnaire (CSQ), and pain and handicap visual analogue scales (VASs). Patients' perceived improvement or worsening of condition was assessed at 6 months. Effect size (ES) and Standardized response mean (SRM) and effect size (ES) were used to evaluate sensitivity to change of the MACTAR.
  
  
  RESULTS
  The MACTAR SRM and ES values (SRM = 0.25; ES = 0.37) were among the highest for the instruments evaluated. For patients considering their condition as improved, the SRM was 0.66 and the ES 1. The 3 disability domains, classified by the International Classification of Functioning, Disability and Health (ICF), most often cited as priorities at baseline remained the most cited at follow-up: mobility (40.9% of patients); community, social and civic life (22.7%); and domestic life (22.4%). At 6 months, 48 patients shifted their priorities, for a decrease in MACTAR SRM and ES values for patients considering their condition improved and an increase in these values for those considering their condition deteriorated.
  
  
  CONCLUSIONS
  Although the MACTAR has similar sensitivity to change as other outcome measures widely used in CLBP, shifts in patient priorities over time are common and influence scores and sensitivity to change.
authors.affiliation: Service de Médecine Physique et Réadaptation, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris, France.
authors.forename: Katherine
authors.initials: K
authors.lastname: Sanchez
authors.forename: Agathe
authors.initials: A
authors.lastname: Papelard
authors.forename: Christelle
authors.initials: C
authors.lastname: Nguyen
authors.forename: Imad
authors.initials: I
authors.lastname: Bendeddouche
authors.forename: Marylène
authors.initials: M
authors.lastname: Jousse
authors.forename: François
authors.initials: F
authors.lastname: Rannou
authors.forename: Michel
authors.initials: M
authors.lastname: Revel
authors.forename: Serge
authors.initials: S
authors.lastname: Poiraudeau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult