title: Problem areas identified as important to older adults with lumbar spinal stenosis.
abstract: BACKGROUND
  There is growing concern that patient-reported outcomes (PROs) commonly used in clinical research evaluating treatments such as epidural steroid injections (ESIs) for lumbar spinal stenosis may not adequately capture outcomes of greatest importance to older adults.
  
  
  OBJECTIVE
  The purpose of the study was to determine what outcomes are most important to older adults with spinal stenosis, how well commonly used PROs reflect what is most important to these participants, and which outcomes older adults with spinal stenosis would want improved to consider having ESI.
  
  
  METHODS
  This is an outcome prioritization study.
  
  
  METHODS
  Community sample of 33 older adults with spinal stenosis were included.
  
  
  METHODS
  The outcome measures were Swiss Spinal Stenosis Questionnaire and Roland-Morris Disability Questionnaire.
  
  
  METHODS
  The methods involve individual sorting and ranking exercises followed by facilitated focus groups.
  
  
  RESULTS
  Highest rated problem areas were "experiencing pain/discomfort" (88% of participants), "problems with physical function" (85%), "difficulty exercising" (73%), "difficulty participating in hobbies and leisure activities" (55%), and "problems with weakness" (52%). Only 10 of the 24 Roland-Morris Disability Questionnaire items were rated by 50% or more of participants experiencing them as important enough to warrant ESI treatment.
  
  
  CONCLUSIONS
  Older adults with spinal stenosis rated problems related to pain and physical function as the most important outcomes to them. However, difficulty exercising and difficulty participating in hobbies and leisure activities were also among the most highly rated and were two areas not typically assessed in treatment studies. Commonly used PROs in spinal stenosis treatment studies may be insufficient to comprehensively assess outcomes from the patient perspective.
authors: University of Washington, Departments of Health Services and Medicine, 1208 NE 43rd St, Seattle, WA 98195, USA. Electronic address: toddce@uw.edu.
authors: Todd C
authors: TC
authors: Edwards
authors: University of Washington, Departments of Health Services and Medicine, 1208 NE 43rd St, Seattle, WA 98195, USA.
authors: Danielle C
authors: DC
authors: Lavallee
authors: University of Washington, Departments of Health Services and Medicine, 1208 NE 43rd St, Seattle, WA 98195, USA.
authors: Zoya
authors: Z
authors: Bauer
authors: University of Washington, Departments of Health Services and Medicine, 1208 NE 43rd St, Seattle, WA 98195, USA.
authors: Bryan A
authors: BA
authors: Comstock
authors: University of Washington, Departments of Health Services and Medicine, 1208 NE 43rd St, Seattle, WA 98195, USA.
authors: Jeffrey G
authors: JG
authors: Jarvik
authors: University of Washington, Departments of Health Services and Medicine, 1208 NE 43rd St, Seattle, WA 98195, USA.
authors: Donald L
authors: DL
authors: Patrick
authors: University of Texas Southwestern Medical Center, Dallas Veterans Administration, Department of Internal Medicine, 5323 Harry Hines Blvd, Dallas, TX 75390, USA.
authors: Una E
authors: UE
authors: Makris
authors: University of Washington, Departments of Health Services and Medicine, 1208 NE 43rd St, Seattle, WA 98195, USA.
authors: Janna L
authors: JL
authors: Friedly
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise; D005260:Female; D006801:Humans; D007268:Injections, Epidural / Q000379:methods; D008159:Lumbar Vertebrae / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement; D011788:Quality of Life; D012107:Research Design; D013130:Spinal Stenosis / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Epidural steroid injections; Lumbar spinal stenosis; Outcomes; Patient centered; Prioritization; Treatment