Crosswalking 4 Pain Impact Measures in a Nationally Representative Sample of Adults With Back Pain

Graham T DiGuiseppi; Maria Orlando Edelen; Anthony Rodriguez; Mary Slaughter; Ron D Hays; Chengbo Zeng; Ian D Coulter; Patricia M Herman

doi:10.1016/j.apmr.2024.09.007

Crosswalking 4 Pain Impact Measures in a Nationally Representative Sample of Adults With Back Pain

Arch Phys Med Rehabil. 2024 Sep 26:S0003-9993(24)01258-9. doi: 10.1016/j.apmr.2024.09.007. Online ahead of print.

Authors

Graham T DiGuiseppi¹, Maria Orlando Edelen², Anthony Rodriguez³, Mary Slaughter⁴, Ron D Hays⁵, Chengbo Zeng⁶, Ian D Coulter⁴, Patricia M Herman⁴

Affiliations

¹ RAND, Pittsburgh, PA. Electronic address: gdiguise@rand.org.
² RAND, Boston, MA; Patient Reported Outcomes, Value and Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA.
³ RAND, Boston, MA.
⁴ RAND, Santa Monica, CA.
⁵ Division of General Internal Medicine and Health Services Research, UCLA Department of Medicine, Los Angeles, CA.
⁶ Patient Reported Outcomes, Value and Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA.

PMID: 39341440
DOI: 10.1016/j.apmr.2024.09.007

Abstract

Objective: To generate crosswalk equations and tables for 4 pain impact measures: the Impact Stratification Score (ISS), Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and the Pain, Enjoyment of Life and General Activity Scale (PEG).

Design: Cross-sectional survey assessing demographics and pain impact. Crosswalks were developed using item-response theory (IRT) cocalibrations and linear regressions between the ISS, ODI, RMDQ, and PEG.

Setting: Online panel.

Participants: Population-based sample of United States adults aged 18 and older. Eligibility criteria were reporting current back pain, not reporting 2 fake health conditions, and having data for 2 or more pain measures (N=1530; 37% of sample). Crosswalks were developed (n=1030) and cross-validated in a subsample of 500 participants (n=125 randomly sampled from each ISS quartile).

Interventions: Not applicable.

Main outcome measures: ISS, ODI, RMDQ, and the PEG.

Results: Associations of the ISS with the PEG and ODI met the criteria for IRT cocalibration. Other measure pairs were crosswalked using regression. Associations were strongest between the PEG and the ISS (r=0.87, normalized mean absolute error [NMAE]=0.38) and between the ODI and the ISS (r=0.85, NMAE=0.39). Associations were weakest between the PEG and the RMDQ (r=0.69, R²=0.48, NMAE: 0.55-0.58). Regression equations and IRT accounted for 48%-64% of the variance (NMAE: 0.38-0.58) in corresponding pain measures in the cross-validation sample.

Conclusions: The crosswalks between the ISS and common legacy pain measures created in this study of a nationally representative sample of United States adults with back pain can be used to estimate 1 pain impact measure from another. Further evaluation in clinical samples is recommended.

Keywords: Back pain; Back pain measures; IRT; Impact Stratification Score; Oswestry Disability Index; Pain, Enjoyment of Life and General Activity Scale (PEG); Roland-Morris Disability Questionnaire; crosswalks; linking.