Assessing Back Pain: Does the Oswestry Disability Questionnaire Accurately Measure Function in Ankylosing Spondylitis?

2010 ◽  
Vol 37 (6) ◽  
pp. 1211-1213 ◽  
Author(s):  
FINBAR D. O’SHEA ◽  
REENA RIARH ◽  
ANNEPA ANTON ◽  
ROBERT D. INMAN
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Pain Score ◽  
Global Assessment ◽  
Patient Global Assessment ◽  
Assessment Score ◽  
Pain Scores ◽  
Disability Questionnaire ◽  
The Mean ◽  
Oswestry Disability Questionnaire

Objective.To determine whether the Oswestry Disability Questionnaire (ODQ) can be used to assess the degree of pain or disability in patients with ankylosing spondylitis (AS).Methods.The ODQ was administered to a cohort of patients with AS. The resulting pain scores were correlated to the conventional measures in AS, the Bath AS Disease Activity Index and Functional Index (BASDAI and BASFI), as well as the Total and Nocturnal Back Pain scores, and the patient global assessment score.Results.A total of 49 patients with AS were assessed (38 men, 11 women), mean age 40 years (range 17–68). The mean ODQ score was 40/100 (range 0–92), the mean BASDAI 3.7/10 (range 0–9.5), the mean BASFI 3.3/10 (range 0–9.7), the mean total back pain score 3.7/10 (range 0–10), and the mean patient global assessment score 3.6/10 (range 0–10). Correlation between the ODQ and the traditional AS outcome measures was very good, with a correlation coefficient of r = 0.73 (BASFI) and r = 0.70 (BASDAI). Correlations between the ODQ and the total back pain score (r = 0.70) and the patient self-reported global assessment (r = 0.61) were good.Conclusion.The strong correlations between the ODQ and BASFI and BASDAI indicate that it identifies both activity and function domains in AS. This is the first demonstration of a role for this outcome measure in the assessment of patients with AS.

scholarly journals OP0008 DEVELOPMENT AND VALIDATION OF AN ALTERNATIVE ANKYLOSING SPONDYLITIS DISEASE ACTIVITY SCORE WHEN PATIENT GLOBAL ASSESSMENT IS UNAVAILABLE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 6-6
Author(s):  
A. Ortolan ◽  
S. Ramiro ◽  
F. A. Van Gaalen ◽  
T. K. Kvien ◽  
R. B. M. Landewé ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Psychometric Properties ◽  
Global Assessment ◽  
Disease Activity Score ◽  
Validation Cohort ◽  
Patient Global Assessment ◽  
Activity Score ◽  
Research Support ◽  
Low Disease Activity

Background:Ankylosing Spondylitis Disease Activity Score (ASDAS) is a composite index measuring disease activity in axial spondyloarthritis (axSpA). It includes questions from the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Patient Global Assessment (PGA), and inflammation biomarkers. However, ASDAS calculation is not always possible because PGA is sometimes not collected.Objectives:To develop an alternative ASDAS to be used in research settings when PGA is unavailable.Methods:Longitudinal data from 4 axSpA cohorts and 2 RCTs were combined. Observations were randomly split in a development (N=1026) and a validation cohort (N=1059). Substitutes of PGA by BASDAI total score, single or combined individual BASDAI questions, and a constant value, were considered. In the development cohort, conversion factors for each substitute were defined by Generalized Estimating Equations. Validation was performed in the validation cohort according to the OMERACT filter, taking into consideration: 1) Truth (agreement with original-ASDAS in the continuous score, by intraclass correlation coefficient -ICC- and in disease activity states, by weighted kappa) 2) Discrimination (standardized mean difference –SMD- of ASDAS scores between high/low disease activity states defined by external anchors e.g Patient Acceptable Symptom State –PASS-; agreement -kappa- in the % of patients reaching ASDAS improvement criteria according to alternative vs. original formulae) 3) Feasibility.Results:Taking all psychometric properties into account and comparing the different formulae (Table), alternative-ASDAS using BASDAI total as PGA replacement proved to be: 1) truthful (agreement with original-ASDAS: ICC=0.98, kappa=0.90); 2) discriminative: it could discriminate between high/low disease activity states (e.g. scores between PASS no/yes: SMD=1.37 versus original-ASDAS SMD=1.43) and was sensitive to change (agreement with original-ASDAS in major improvement/clinically important improvement criteria: kappa=0.93/0.88; 3) feasible (BASDAI total often available; conversion coefficient≈1).Table.Psychometric properties of alternative ASDAS formulaeConclusion:Alternative-ASDAS using BASDAI total score as PGA replacement is the most truthful, discriminative and feasible instrument. This index enables ASDAS calculation in existing cohorts without PGA.Disclosure of Interests:Augusta Ortolan: None declared, Sofia Ramiro: None declared, Floris A. van Gaalen: None declared, Tore K. Kvien Grant/research support from: Received grants from Abbvie, Hospira/Pfizer, MSD and Roche (not relevant for this abstract)., Consultant of: Have received personal fees from Abbvie, Biogen, BMS, Celltrion, Eli Lily, Hospira/Pfizer, MSD, Novartis, Orion Pharma, Roche, Sandoz, UCB, Sanofi and Mylan (not relevant for this abstract)., Paid instructor for: Have received personal fees from Abbvie, Biogen, BMS, Celltrion, Eli Lily, Hospira/Pfizer, MSD, Novartis, Orion Pharma, Roche, Sandoz, UCB, Sanofi and Mylan (not relevant for this abstract)., Speakers bureau: Have received personal fees from Abbvie, Biogen, BMS, Celltrion, Eli Lily, Hospira/Pfizer, MSD, Novartis, Orion Pharma, Roche, Sandoz, UCB, Sanofi and Mylan (not relevant for this abstract)., Robert B.M. Landewé Consultant of: AbbVie; AstraZeneca; Bristol-Myers Squibb; Eli Lilly & Co.; Galapagos NV; Novartis; Pfizer; UCB Pharma, Pedro M Machado Consultant of: PMM: Abbvie, Celgene, Janssen, Lilly, MSD, Novartis, Pfizer, Roche and UCB, Speakers bureau: PMM: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche and UCB, Adeline Ruyssen-Witrand Grant/research support from: Abbvie, Pfizer, Consultant of: Abbvie, BMS, Lilly, Mylan, Novartis, Pfizer, Sandoz, Sanofi-Genzyme, Astrid van Tubergen Consultant of: Novartis, Caroline Bastiaenen: None declared, Désirée van der Heijde Consultant of: AbbVie, Amgen, Astellas, AstraZeneca, BMS, Boehringer Ingelheim, Celgene, Cyxone, Daiichi, Eisai, Eli-Lilly, Galapagos, Gilead Sciences, Inc., Glaxo-Smith-Kline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, UCB Pharma; Director of Imaging Rheumatology BV

The analgesic efficacy of liposomal bupivacaine compared with bupivacaine hydrochloride for the prevention of postoperative pain: a systematic review and meta-analysis with trial sequential analysis

2021 ◽  
pp. rapm-2020-102427
Author(s):  
Hanns-Christian Dinges ◽  
Thomas Wiesmann ◽  
Berit Otremba ◽  
Hinnerk Wulf ◽  
Leopold H Eberhart ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Pain Score ◽  
Meta Analysis ◽  
End Points ◽  
Liposomal Bupivacaine ◽  
Bupivacaine Hydrochloride ◽  
Pain Scores ◽  
Score Difference ◽  
The Mean

Background/ImportanceLiposomal bupivacaine (LB) is a prolonged release formulation of conventional bupivacaine designed for prolonging local or peripheral regional single injection anesthesia. To this day, the benefit of the new substance on relevant end points is discussed controversial.ObjectiveThe objective was to determine whether there is a difference in postoperative pain scores and morphine consumption between patients treated with LB and bupivacaine hydrochloride in a systematic review and meta-analysis.Evidence reviewRandomized controlled trials (RCT) were identified in Embase, CENTRAL, MEDLINE and Web of Science up to May 2020. Risk of bias was assessed using Cochrane methodology. Primary end points were the mean pain score difference and the relative morphine equivalent (MEQ) consumption expressed as the ratio of means (ROM) 24 and 72 hours postoperatively.Findings23 RCTs including 1867 patients were eligible for meta-analysis. The mean pain score difference at 24 hours postoperatively was significantly lower in the LB group, at −0.37 (95% CI −0.56 to −0.19). The relative MEQ consumption after 24 hours was also significantly lower in the LB group, at 0.85 (0.82 to 0.89). At 72 hours, the pain score difference was not significant at −0.25 (−0.71 to 0.20) and the MEQ ratio was 0.85 (0.77 to 0.95).ConclusionThe beneficial effect on pain scores and opioid consumption was small but not clinically relevant, despite statistical significance. The effect was stable among all studies, indicating that it is independent of the application modality.

scholarly journals Comparison of Visual Analog Pain Score Reported to Physician vs Nurse in Nonoperatively Treated Foot and Ankle Patients

2018 ◽  
Vol 39 (12) ◽  
pp. 1444-1448 ◽  
Author(s):  
Kevin D. Martin ◽  
Trevor McBride ◽  
Jeffrey Wake ◽  
Jeffrey Preston Van Buren ◽  
Cuyler Dewar
Keyword(s):  
Pain Score ◽  
Operative Procedure ◽  
Patient Reported Outcome Measures ◽  
Mean Difference ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Vas Score ◽  
Pain Scores ◽  
Patient Reported ◽  
The Mean

Background: Patient-reported outcome measures (PROMs) are taking a more prominent role in orthopedics as health care seeks to define treatment outcomes. The visual analog scale (VAS) is considered a reliable measure of acute pain. A previous study found that operative candidates’ VAS pain score was significantly higher when reported to the surgeon compared to the nurse. This study’s aim is to examine whether this phenomenon occurs in patients that do not undergo an operative procedure. We hypothesized that patients’ VAS pain scores reported to the surgeon vs the nurse would be the same. Methods: This study is a retrospective cohort of 201 consecutive nonoperative foot and ankle patients treated by a single surgeon. Patients were asked to rate pain intensity by a nurse followed by the surgeon using a horizontal VAS, 0 “no pain” to 10 “worst pain.” Differences in reported pain levels were compared with data from the previous cohort of 201 consecutive operative foot and ankle patients. Results: The mean VAS score reported to the nurse was 3.2 whereas the mean VAS score reported to the surgeon was 4.2 ( P < .001). The mean difference in VAS scores reported for operative patients was 2.9, whereas the mean difference for nonoperative patients was 1.0 ( P < .001). Conclusion: This study found statistically significant differences between VAS pain scores reported to the surgeon vs the nurse in nonoperative patients. These results support the trend found in our previous study, where operative patients reported significantly higher pain scores to the surgeon vs the nurse. The mean difference between reported pain scores was significantly higher for operative patients compared to nonoperative patients. Level of Evidence: Level III, comparative study.

scholarly journals A prospective study on pain score with transperineal prostatic gold seed fiducial implantation under local anesthetic alone

2013 ◽  
Vol 7 (3-4) ◽  
pp. e202-6 ◽  
Author(s):  
Colin I. Tang ◽  
Perakaa Sethukavalan ◽  
Patrick Cheung ◽  
Gerard Morton ◽  
Geordi Pang ◽  
...  
Keyword(s):  
Pain Score ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Seed Implantation ◽  
Pain Scores ◽  
Patient Pain ◽  
Procedural Complications ◽  
Gold Seed ◽  
The Mean ◽  
A Prospective Study

Background: The purpose of this study was to monitor patient pain score with transperineal prostatic gold seed implantation in the absence of conscious sedation.Methods: All patients who were scheduled for image-guided external beam radiation (IGRT) and referred for gold seed fiducials were eligible to participate. Gold seed implants were performed by two radiation oncologists between December 2007 and April 2008. Patients received only local and deep anesthetic. No patients had prophylactic IV cannulation for the procedure. Three gold seeds were inserted transperineally into the prostate. A visual analogue scale from 0 to 10 was used to assess the pain at baseline, local and deep anesthetic infiltration, with each seed drop, and after the completion of the procedure.Results: A total of 30 patients were accrued to this study. The highest recorded increase in pain score was at the time point of deep local anesthesia, at which the mean pain score was 3.8. The mean pain scores at each seed drop were 0.8 (standard deviation [SD]=1.24), 1 (SD=1.26), and 0.5 (SD=0.90), respectively. All gold seed insertion procedures were well-tolerated, with no patient shaving significant pain post-procedure, and no significant procedural complications. There were only slight increases in dysuria, urinary frequency, constipation, urinary retention and flatulence in 7 patients – none of which required intervention.Interpretation: Transperineal ultrasound-guided gold seed implantation without conscious sedation is well-tolerated and associated with a low complication rate. It is a convenient outpatient procedure obviating the need for resource intensive postoperative monitoring.

Validation in Colombia of the Oswestry Disability Questionnaire in Patients With Low Back Pain

Spine ◽  
2011 ◽  
Vol 36 (26) ◽  
pp. E1730-E1735 ◽  
Author(s):  
Kelly Payares ◽  
Luz Helena Lugo ◽  
Victoria Morales ◽  
Alejandro Londoño
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Disability Questionnaire ◽  
Oswestry Disability Questionnaire

scholarly journals Risk factors of postoperative low back pain for low-grade isthmic spondylolisthesis: a retrospective study

2019 ◽  
Vol 48 (3) ◽  
pp. 030006051989079
Author(s):  
Fulin Guan ◽  
Hongna Yin ◽  
Lin Zhu ◽  
Zhizhuang Zhang ◽  
Qichang Gao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Back Pain ◽  
Back Pain ◽  
Retrospective Study ◽  
Pain Score ◽  
Disc Height ◽  
Low Grade ◽  
Low Back ◽  
Isthmic Spondylolisthesis ◽  
The Mean

Objective To investigate the risk factors of postoperative low back pain (LBP) following posterior lumbar interbody fusion (PLIF) surgery for low-grade isthmic spondylolisthesis (IS). Methods This retrospective study enrolled patients with IS that underwent PLIF between January 2011 and January 2016. Demographic, clinical, surgical and radiological characteristics were analysed to determine associations between these characteristics and LBP as measured using a visual analogue scale (VAS) pain score. Results A total of 192 patients were enrolled in the study. The mean VAS pain score of LBP decreased significantly after surgery. The mean preoperative VAS pain score was significantly greater in patients with symptoms of ≤3 years duration compared with those with symptoms lasting >3 years. The postoperative VAS pain score was significantly lower in patients with grade 1 slippage compared with those with grade 2 slippage. There was a significant correlation between preoperative to postoperative change of VAS pain score and postoperative disc height ( r = 0.99). Conclusion PLIF significantly improved LBP in patients with low-grade IS, although patients still reported some postoperative LBP. The grade of slippage was a risk factor for postoperative LBP. Restoring the disc height appeared to improve LBP.

P91 Post-operative pain in neurosurgery

2019 ◽  
Vol 90 (3) ◽  
pp. e46.1-e46
Author(s):  
PM Haigh ◽  
F Al-Hatimi ◽  
H Stewart ◽  
S Rajagopal ◽  
S Khalifa ◽  
...  
Keyword(s):  
Pain Score ◽  
Spinal Surgery ◽  
Foramen Magnum ◽  
P Value ◽  
Inflammatory Agent ◽  
Pain Scores ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Significant Difference ◽  
The Mean

ObjectivesAre the analgesic guidelines for those neurosurgical operations associated with major and complex major pain consistently followed? Is there a correlation between adherence and post-operative pain?DesignPatients undergoing spinal surgery and foramen magnum decompressions were visited on the first post-operative day (D1). They provided their pain score subjectively (0=nil; 10=worst ever experienced); objectively we recorded whether they could move in/out of bed without pain limitation.Subjectsn=57 consecutive patients undergoing elective major and complex major pain neurosurgery between April and June 2018 at the NHNN, Queen Square.MethodsA proforma was completed on D1. The patients consented to take part and answered three questions. We examined what (if any) analgesics they were admitted on, and what had been prescribed to cover the post-operative period. This was compared against the appropriate guideline for that category of operation.ResultsGuidelines were only followed in 16/57 (28.1%) cases; not followed in 41/57 (71.9%). On an unpaired T-test: 2-tailed P value=0.0195. Where guidelines were followed, the mean pain score reported was: 3.75 (SD 2.72) Where not followed, the mean pain score was 5.46 (SD 2.29). So with a 95% confidence interval −3.41 to −0.29, there is a significant difference between the pain in those prescribed according to the guidelines and those that were not.ConclusionsThe pain guidelines are not routinely followed. Most commonly this was due to no prescription for a non-steroidal anti-inflammatory agent. We suggest regular sessions of education of the guidelines. Cycle 2 closed the loop of the audit. We re-reviewed adherence and pain scores and found guidelines were followed in 34% of cases, which represented a 6% improvement. On a paired two-tailed P value=0.0794. The mean pain score where guidelines were followed=3.42 (SD1.62) against a mean=4.74 (SD 1.89) where guidelines were not followed.

scholarly journals AB0703 WHICH OF THE ASDAS OR BASDAI CORRELATES BETTER WITH PHYSICIAN GLOBAL ASSESSMENT?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1647.4-1647
Author(s):  
K. Maatallah ◽  
W. Triki ◽  
H. Ferjani ◽  
D. Kaffel ◽  
W. Hamdi
Keyword(s):  
New York ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Global Assessment ◽  
Cross Sectional Study ◽  
Face Validity ◽  
Physician Global Assessment ◽  
Cross Sectional ◽  
Asas Criteria ◽  
The Mean

Background:Ankylosing Spondylitis Disease Activity score (ASDAS) was developed because of the limitations of Bath Ankylosing Spondylitis Disease Index (BASDAI) of being totally patient-derived with limited face and construct validity. ASDAS includes inflammatory markers that were aimed to increase its face validity by representing a different ‘objective’ domain of disease activity that was not included in BASDAI.Objectives:The aim of our study was to compare correlation of ASDAS and BASDAI with physician global assessment (PhGA) in order to know which is more reliable.Methods:Cross-sectional study including patients with SpA according to the ASAS criteria of 2009 and/or New York modified criteria. The erythrocyte sedimentation rate (ESR) and the C-reactive protein (crp) were measured. The disease activity was assessed by BASDAI and ASDAS. Physician global assessment (PhGA) was rated by 0–100 numeric score. We correlated disease activity indices with physician global assessment by Pearson coefficient.Results:A total of 110 patients (68 men and 42 women) with a mean age of 43.18 ±12.34 [19-79] years was collected. The mean disease duration was 5.99±2.31 [1-10] years. The mean ESR and CRP were respectively 28.41±21.51 [2-110] and 15.56 ±23.84 [0-153] mg/l. ESR was correlated with PhGA (p=0.06, r=0.300), however CRP was not correlated with PhGA (p=0.134, r=0.165). The mean ASDAS-ESR and ASDAS-CRP were respectively 2.93±1.05 [0.83-5.65] and 2.81±0.97 [0.29-4.77]. The mean BASDAI was 4.42±2.23 [0-9.2]. The mean PhGA was 5.43 ±2.31 [1-10]. The BASDAI correlated with PhGA (p=0.007, r=0.307). In addition, ASDAS-ESR and ASDAS-CRP correlated with PhGA (p=0.001, r=0.372, p=0.001, r=0.391) respectively.Conclusion:In conclusion both BASDAI and ASDAS are equal, with a superiority nonetheless for the ASDAS since it correlated stronger with PhGA.Acknowledgments:NoneDisclosure of Interests:None declared

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