Unpacking the impact of chronic pain as measured by the impact stratification score.
Bifactor
Chronic low back pain
Impact stratification
PROMIS®
Patient-reported outcomes
Reliability
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
23 Sep 2022
23 Sep 2022
Historique:
received:
01
02
2022
accepted:
12
09
2022
entrez:
23
9
2022
pubmed:
24
9
2022
medline:
28
9
2022
Statut:
epublish
Résumé
In 2014, the National Institute of Health Pain Consortium's research task force on research standards for chronic low back pain (CLBP) proposed a measure that could be used to stratify patients by the impact CLBP has on their lives, namely the Impact Stratification Score (ISS). This study examines the dimensionality of the ISS and support for its single total score, and evaluates its overall psychometric properties. The sample included 1677 chiropractic patients being treated for CLBP and chronic neck pain, had an average age of 49, 71% female, and 90% White. Study participants completed the PROMIS-29 v2.1 profile survey that contains the 9 ISS items. The ISS was evaluated using item-total correlations, Cronbach's alpha, factor analysis (i.e., correlated factors and bifactor models), and item response theory (IRT). Reliability indices and item properties were evaluated from bifactor and IRT models, respectively. Item-total correlations were high (0.64-0.84) with a Cronbach's alpha of 0.93. Eigenvalues suggested the possibility of two factors corresponding to physical function and pain interference/intensity. Bifactor model results indicated that data were essentially unidimensional, primarily reflecting one general construct (i.e., impact) and that after accounting for 'impact' very little reliable variance remained in the two group factors. General impact scores were reliable (omegaH = .73). IRT models showed that items were strong indicators of impact and provided information across a wide range of the impact continuum and offer the possibility of a shorter 8-item ISS. Finally, it appears that different aspects of pain interference occur prior to losses in physical function. This study presents evidence that the ISS is sufficiently unidimensional, covers a range of chronic pain impact and is a reliable measure. Insights are obtained into the sequence of chronic pain impacts on patients' lives.
Sections du résumé
BACKGROUND
BACKGROUND
In 2014, the National Institute of Health Pain Consortium's research task force on research standards for chronic low back pain (CLBP) proposed a measure that could be used to stratify patients by the impact CLBP has on their lives, namely the Impact Stratification Score (ISS). This study examines the dimensionality of the ISS and support for its single total score, and evaluates its overall psychometric properties.
METHODS
METHODS
The sample included 1677 chiropractic patients being treated for CLBP and chronic neck pain, had an average age of 49, 71% female, and 90% White. Study participants completed the PROMIS-29 v2.1 profile survey that contains the 9 ISS items. The ISS was evaluated using item-total correlations, Cronbach's alpha, factor analysis (i.e., correlated factors and bifactor models), and item response theory (IRT). Reliability indices and item properties were evaluated from bifactor and IRT models, respectively.
RESULTS
RESULTS
Item-total correlations were high (0.64-0.84) with a Cronbach's alpha of 0.93. Eigenvalues suggested the possibility of two factors corresponding to physical function and pain interference/intensity. Bifactor model results indicated that data were essentially unidimensional, primarily reflecting one general construct (i.e., impact) and that after accounting for 'impact' very little reliable variance remained in the two group factors. General impact scores were reliable (omegaH = .73). IRT models showed that items were strong indicators of impact and provided information across a wide range of the impact continuum and offer the possibility of a shorter 8-item ISS. Finally, it appears that different aspects of pain interference occur prior to losses in physical function.
CONCLUSIONS
CONCLUSIONS
This study presents evidence that the ISS is sufficiently unidimensional, covers a range of chronic pain impact and is a reliable measure. Insights are obtained into the sequence of chronic pain impacts on patients' lives.
Identifiants
pubmed: 36151555
doi: 10.1186/s12891-022-05834-4
pii: 10.1186/s12891-022-05834-4
pmc: PMC9503239
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
884Subventions
Organisme : NCCIH NIH HHS
ID : R01 AT010402
Pays : United States
Organisme : NCCIH NIH HHS
ID : 1R01AT010402-01A1
Pays : United States
Informations de copyright
© 2022. The Author(s).
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