COSMIN database

Toward the Development of a Universal Outcome Instrument for Spine Trauma: A Systematic Review and Content Comparison of Outcome Measures Used in Spine Trauma Research Using the ICF as Reference

Oner, F. C., Jacobs, W. C., Lehr, A. M., Sadiqi, S., Post, M. W., Aarabi, B., Chapman, J. R., Dvorak, M. F., Fehlings, M. G., Kandziora, F., Rajasekaran, S., and Vaccaro, A. R.
STUDY DESIGN: A systematic literature review.

OBJECTIVE: The aim of this study was (1) to identify patient-reported and clinician-based outcome measures most frequently used to evaluate the function and health of spine trauma patients, (2) to identify and quantify the concepts of these measures using the International Classification of Functioning, Disability, and Health (ICF) as reference, and (3) to describe their clinimetric properties.

SUMMARY OF BACKGROUND DATA: There is a real need for a disease-specific outcome instrument to measure the effect size of various treatment options in a variety of traumatic spinal column injuries.

METHODS: A systematic literature search was conducted in several databases. From the included studies, outcome measures were extracted. The items and underlying concepts of the identified outcome measures were specified and linked to the ICF categories. Finally, as far as available in literature, the clinimetric properties of the obtained measures were analyzed.

RESULTS: Out of 5117 screened references, 245 were included, and 17 different frequently used outcome measures were identified. Meaningful concepts of the items and response options of the retrieved outcome measures were linked to a total of 105 different ICF categories, aggregated to 57 first- or second-level categories. The categories were linked to the components activities and participation (n = 31), body functions (n = 17), environmental factors (n = 8), and body structures (n = 1). Overall, there is only limited evidence on the measurement properties, except for some disease-specific questionnaires, such as Oswestry Disability Index, Roland-Morris Disability Questionnaire, Neck Disability Index, and Cervical Spine Outcome Questionnaire.

CONCLUSION: The current systematic literature review revealed great diversity in the use and content of outcome measures to evaluate the functioning and health of spine trauma patients, with 17 different outcome measures linked to 57 unique ICF categories. This study creates an evidence base for a consensus meeting during which a core set of ICF categories for outcome measurement in spine trauma will be decided.

Spine (Phila Pa 1976)
Publication year:
Biological and physiological variables:
Biological and physiological variables
Symptom status:
Physical state
Functional status:
Physical functioning
Role functioning
Social functioning
Adults (18-65)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
Injury, poisoning and certain other consequences of external causes
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
6 - Clinical rating scales
AIS - ASIA Impairment Scale
CSOQ - Cervical Spine Outcome Questionnaire
DPS - Denis Pain Scale
DWS - Denis Work Scale
FS - Frankel Scale
HSS - Hannover Spine Score
LBOS - Low Back Outcome Scale
NDI - Neck Disability Index    
ODI - Oswestry Disability Index   
PS - Prolo Scale [alias: Prolo Score] [alias: Prolo Economic Functional Rating Scale]
RMDQ - Roland Morris Disability Questionnaire    
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: Medical Outcomes Study (MOS) SF-36]]    |  | also see:
VASSS - Visual Analogue Scale Spine Score