Paper #III-2

THE RELIABILITY OF USING QUESTIONNAIRES TO DETERMINE WHETHER SPINE PATIENTS HAVE LEG OR BACK DOMINANT PAIN

J Whitcomb Pollock, MD

Ottawa, ON

Purpose

The ability to differentiate leg dominant or back dominant pain is important in identifying patients appropriate for surgery and stratifying populations for research purposes. The aim of this prospective, test-retest study was to determine whether spine patients have leg dominant or back dominant pain using questionnaires.

Methods

Ten different measures of assessment for back or leg pain were placed randomly into questionnaires, which were completed by 34 patients along with the revised Oswestry Low Back Questionnaire. Within a 2-week interval, a randomly reorganized retest questionnaire containing the identical ten items was distributed. Kappa statistics were used to determine the test-retest reliability and to compare against the surgeon's clinical assessment.

Results

34 patients completed both questionnaires. The kappa values for the separate items in the questionnaire ranged from 0.23 to 0.56. The clinical correlation with items in the questionnaire ranged from 0.26 to 0.57.

Discussion

All ten items included in the questionnaire appeared to lack sufficient internal consistency and test-retest reliability for use in clinical application. Patients appear to be unable to accurately and reliably determine the predominant location of their pain.