title: How much does the Dallas Pain Questionnaire score have to improve to indicate that patients with chronic low back pain feel better or well?
abstract: OBJECTIVE
  The Dallas Pain Questionnaire (DPQ) assesses the impact of low back pain (LBP) on four components (0-100) of daily life. We estimated the minimal clinically important improvement (MCII) and the patient acceptable symptom state (PASS) values of DPQ in LBP patients.
  
  
  METHODS
  142 patients with LBP lasting for at least 4 weeks completed a battery of questionnaires at baseline and 6 months later. Questions for MCII addressed patient-reported response to treatment at 6 months on a five-point Likert scale, while a yes/no question concerning satisfaction with present state was used to determine PASS. MCII was computed as the difference in mean DPQ scores between patients reporting treatment as effective vs. patients reporting treatment as not effective, and PASS was computed as the third quartile of the DPQ score among patients who reported being satisfied with their present state.
  
  
  RESULTS
  MCII values were 22, 23, 2 and 10 for daily activities, work and leisure, social interest, and anxiety/depression, respectively. PASS values were 29, 23, 20 and 21 for the four components, respectively. The PASS total score threshold of 24 correctly classified 84.1 % of the patients who reported being unsatisfied with their present state, and 74.7 % of patients reported being satisfied.
  
  
  CONCLUSIONS
  These values give information of paramount importance for clinicians in interpreting change in DPQ values over time. Authors should be encouraged to report the percentage of patients who reach MCII and PASS values in randomized clinical trials and cohort studies to help clinicians to interpret clinical results.
authors.affiliation: Service de Rhumatologie, C.H.U. Henri Mondor, Créteil, France. marc.marty@free.fr.
authors.forename: M
authors.initials: M
authors.lastname: Marty
authors.affiliation: Service d'épidémiologie Clinique, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Courvoisier
authors.affiliation: Service de Rhumatologie, C.H.U Pitié-Salpêtrière, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Foltz
authors.affiliation: Unité du Dos, CHU Dinant Godinne UcL Namur, Dinant, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Mahieu
authors.affiliation: Département des Sciences de la Motricité, Université de Liège, Liège, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Demoulin
authors.affiliation: Clinique de Médecine Physique et Réadaptation, CHU Brugmann, Brussels, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Gierasimowicz
authors.affiliation: Appareil Locomoteur, CHUV, Lausanne, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Norberg
authors.affiliation: Appareil Locomoteur, CHUV, Lausanne, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: de Goumoëns
authors.affiliation: Réhabilitation Médicale, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Cedraschi
authors.affiliation: Service de Rhumatologie, C.H.U Pitié-Salpêtrière, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Rozenberg
authors.affiliation: Rhumatologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Genevay
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Dallas Pain Questionnaire; Low back pain; Minimal clinically important change; Outcome measures; Patient acceptable stable state