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J Manipulative Physiol Ther. 2003 Oct;26(8):481-92.

Subjective and Objective Numerical Outcome Measure Assessment (SONOMA). A combined outcome measure tool: findings on a study of reliability.

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Pennsylvania State University, York, USA.



To determine the reliability of a combined tool, namely that of Subjective and Objective Numerical Outcome Measure Assessment (SONOMA).


Testing was conducted, limited to patients with neck, midback, or lower back pain, with or without radiculopathy, in an outpatient chiropractic office setting. Test-retest reliability of the objective analysis of SONOMA was carried out on the same day (n = 50) with an interval time period of less than 60 minutes. Between-day reliability of the subjective analysis of SONOMA was carried out with an interval time period of 24 hours (n = 50). Individual and combined parameter reliability was established for the tool.


Short-term objective and between-day subjective reliability coefficients were high. The Pearson correlation coefficient for the combined tool was .96, and the coefficient for the individual parameters ranged from .55 through .93. All these correlations were statistically significant, with a P value not more than .0001.


The SONOMA combined numerical outcome measure tool demonstrated a high degree of reliability. This outcome tool measures directly and therefore reflects patient pain perception, functional status, and provider-driven objective assessment. We believe this tool provides the unique combination of both subjective and objective functional capacity assessment. It should be valuable for day-to-day practical application, as well as considered for future clinical trials and quality-of-care studies. This combined tool shows promise as having a high degree of reliability and, hence, may demonstrate a comprehensive representation of the patient-clinical picture, particularly in regard to functional capacity assessment.

[Indexed for MEDLINE]

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