Japanese orthopaedic association cervical myelopathy evaluation questionnaire (JOACMEQ): Part 5. Determination of responsiveness |
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Authors: | Eiji Wada Mitsuru Fukui Kazuhisa Takahashi Daisaku Takeuchi Hiroshi Hashizume Masahiko Kanamori Noboru Hosono Tsukasa Kanchiku Yuichi Kasai Miho Sekiguchi Shin-ichi Konno Mamoru Kawakami Kazuo Yonenobu |
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Institution: | 1. Spine and Spinal Cord Center, Osaka Police Hospital, Osaka, Japan;2. Laboratory of Statistics, Osaka City University Faculty of Medicine, Osaka, Japan;3. Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan;4. Department of Orthopedic Surgery, Dokkyo Medical University School of Medicine, Shimotsuga-gun, Tochigi Prefecture, Japan;5. Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan;6. Department of Human Science, University of Toyama, Japan;7. Department of Orthopedic Surgery, Japan Community Health Care Organization Hoshigaoka Medical Center, Hirakata, Japan;8. Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan;9. Department of Spinal Surgery and Medical Engineering, Mie University Graduate School of Medicine, Japan;10. Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan;11. Spine Care Center, Wakayama Medical University Kihoku Hospital, Wakayama, Japan;12. Graduate School of Health Care Sciences, Jikei Institute, Osaka, Japan |
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Abstract: | BackgroundIn 1999, the Japanese Orthopaedic Association decided to develop a new Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). The final version of the JOACMEQ, comprising 24 questions and five domains (cervical spine function (CF); upper extremity function (UF); lower extremity function (LF); bladder function (BF); and quality of life (QOL)), was established after three nationwide investigations. The fourth investigation, reported in this paper, was performed to confirm the responsiveness of the questionnaire.MethodsA total of 137 patients with cervical myelopathy were included in the study. Each patient was interviewed twice using the JOACMEQ before and after treatment. At the second interview, the patients self-rated their condition in five domains for “worse,” “somewhat worse,” “no change,” “somewhat better,” or “better,” and these scores were defined as the external assessment rating. The difference of the points in five domains between the first and the second interview was calculated against each external assessment. Based on the results, substantial clinical benefit (SCB) thresholds for the JOACMEQ were determined.ResultsThe statistically significant median values of the acquired points were 17.5 for CF, 16.0 and 21.0 for UF, 27.0 and 20.5 for LF, 13.0 for BF, and 29.0 for QOL. After consideration of the results, the committee decided that an acquired point ≥20 could be interpreted as representing an SCB threshold for the JOACMEQ.ConclusionWe have concluded that a treatment can be judged to be effective for a patient if 1) The patient give all answers for the questions necessary to calculate the functional score of a domain and an increase of ≥20 points is obtained for that score, or 2) The functional score after treatment is > 90 points even if the answer for the unanswered questions was supposed to be the worst possible choice. |
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Keywords: | Corresponding author Director of Spine and Spinal Cord Center Osaka Police Hospital 10-31 Kitayama-cho Tennoji-ward Osaka 5430035 Japan Fax: +81 6 6775 2838 |
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