COSMIN database

Measurement properties of disease-specific questionnaires in patients with neck pain: a systematic review

Schellingerhout, J. M., Verhagen, A. P., Heymans, M. W., Koes, B. W., de Vet, H. C., and Terwee, C. B.
PURPOSE: To critically appraise and compare the measurement properties of the original versions of neck-specific questionnaires.

METHODS: Bibliographic databases were searched for articles concerning the development or evaluation of the measurement properties of an original version of a self-reported questionnaire, evaluating pain and/or disability, which was specifically developed or adapted for patients with neck pain. The methodological quality of the selected studies and the results of the measurement properties were critically appraised and rated using a checklist, specifically designed for evaluating studies on measurement properties.

RESULTS: The search strategy resulted in a total of 3,641 unique hits, of which 25 articles, evaluating 8 different questionnaires, were included in our study. The Neck Disability Index is the most frequently evaluated questionnaire and shows positive results for internal consistency, content validity, structural validity, hypothesis testing, and responsiveness, but a negative result for reliability. The other questionnaires show positive results, but the evidence for each measurement property is mostly limited, and at least 50% of the information on measurement properties per questionnaire is lacking.

CONCLUSIONS: Our findings imply that studies of high methodological quality are needed to properly assess the measurement properties of the currently available questionnaires. Until high quality studies are available, we recommend using these questionnaires with caution. There is no need for the development of new neck-specific questionnaires until the current questionnaires have been adequately assessed.
Qual Life Res
1573-2649 (Electronic)
Publication year:
Symptom status:
Physical state
Functional status:
Cognitive/mental functioning
Physical functioning
Social functioning
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
CNFDS - Copenhagen Neck Functional Disability Scale
CNQ - Core Neck Questionnaire
CWOM - Core Whiplash Outcome Measure
NBQ - Neck Bournemouth Questionnaire
NDI - Neck Disability Index    
NPDS - Neck Pain and Disability Scale   
NPQ - Northwick Park Neck Pain Questionnaire [alias: Northwick Questionnaire]
WDQ - Whiplash Disability Questionnaire