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Global Spine J. 2015 Aug;5(4):329-38. doi: 10.1055/s-0034-1396046. Epub 2015 Mar 13.

Fundamentals of Clinical Outcomes Assessment for Spinal Disorders: Clinical Outcome Instruments and Applications.

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Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard University Medical School, Boston, Massachusetts, United States ; Harvard Center for Population and Development Studies, Harvard School of Public Health, Boston, Massachusetts, United States ; Department of Orthopedic Surgery, University of Basel, Basel, Switzerland.
Department of Orthopedics, Makati Medical Center, Makati City, Philippines.
Department of Orthopedic Surgery, University of Basel, Basel, Switzerland.
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, United States.
Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, United States.
Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China ; The Laboratory and Clinical Research Institute for Pain, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China.


Study Design A broad narrative review. Objectives Outcome assessment in spinal disorders is imperative to help monitor the safety and efficacy of the treatment in an effort to change the clinical practice and improve patient outcomes. The following article, part two of a two-part series, discusses the various outcome tools and instruments utilized to address spinal disorders and their management. Methods A thorough review of the peer-reviewed literature was performed, irrespective of language, addressing outcome research, instruments and tools, and applications. Results Numerous articles addressing the development and implementation of health-related quality-of-life, neck and low back pain, overall pain, spinal deformity, and other condition-specific outcome instruments have been reported. Their applications in the context of the clinical trial studies, the economic analyses, and overall evidence-based orthopedics have been noted. Additional issues regarding the problems and potential sources of bias utilizing outcomes scales and the concept of minimally clinically important difference were discussed. Conclusion Continuing research needs to assess the outcome instruments and tools used in the clinical outcome assessment for spinal disorders. Understanding the fundamental principles in spinal outcome assessment may also advance the field of "personalized spine care."


instruments; outcomes; personalized; questionnaires; spine

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