Accuracy and reproducibility of a retrospective outcome assessement for lumbar spinal stenosis surgery.
BMC Musculoskelet Disord. 2012 May 29;13(1):83
Authors: Kuittinen P, Aalto T, HeikkilÃ?Â¤ T, Leinonen V, Savolainen S, Sipola P, KrÃ?Â¶ger H, Turunen V, Airaksinen O
ABSTRACT: BACKGROUND: Retrospective assessment of surgery outcome is considered problematic. The aims of this study were to evaluate the reproducibility and accuracy of a retrospective outcome assessment of lumbar spinal stenosis surgery with reference to prospective outcome scale measurements. METHOD: Outcome of surgery from 100 lumbar spinal stenosis (LSS) patients was evaluated retrospectively from patient files of a 3-month outpatient visit performed according to a standard clinical protocol by two independent researchers. In the retrospective analysis, outcome was graded as 2=good if the clinical condition had clearly improved, 1=moderate if it had just slightly improved, 0=poor if it had not improved or was even worse than before the surgical treatment (Retrospective 3-point scale). A prospectively assessed Oswestry Disability Index questionnaire (ODI), Visual analogue pain scale (VAS) and a patient satisfaction questionnaire were used as references of standards. Reproducibility of the measurements was evaluated. RESULTS: The retrospective 3-point scale correlated with ODI (r = 0.528; P < 0.001) and VAS (r = 0.368; P < 0.001). The agreement was better in the good and poor outcome than in the moderate outcome. Retrospective 3-point scale demonstrated substantial intra-rater and inter-rater repeatability (kappa = 0.682, P < 0.001 and kappa=0.630, P < 0.001, respectively). CONCLUSIONS: Retrospective assessment of spinal surgery outcome is highly reproducible. Accuracy is highest in the patients with poor and good surgical result.
PMID: 22642923 [PubMed – as supplied by publisher]