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Beitragstitel The 16-item version of the SRS-instrument shows better structural validity than the 20-item version in young patients with spinal deformity
Autoren
  1. Anne F. Mannion Schulthess Clinic, Zurich, Switzerland Vortragender
  2. Achim Elfering University of Bern
  3. Tamas F Fekete
  4. Ian Harding
  5. Marco Monticone
  6. Peter Obid
  7. Thomas Niemeyer
  8. Ulf Liljenqvist
  9. Andreas Boss
  10. Alba Vila-Casademunt
  11. Francisco Sanchez Perez-Grueso Hospital Universitario La Paz
  12. Javier Pizones Hospital Universitario La Paz
  13. Ferran Pellise Hospital Vall d’Hebron
  14. Sarah Richner-Wunderlin
  15. Laura Zimmermann
  16. Frank Stefan Kleinstück Schulthess Klinik Zürich
  17. Ibrahim Obeid Pellegrin Bordeaux University Hospital
  18. Ahmet Alanay Acibadem Mehmet Ali Aydınlar University School of Medicine, Department of Orthopedics and Traumatology
  19. Joan Bago
Präsentationsform Poster
Themengebiete
  • A03 - Wirbelsäule
Abstract Introduction Previously, in patients with adult spinal deformity, 16 of the non-management items of the SRS-instrument showed a significantly better fit to the theoretical four-factor model (pain, function, self-image, mental health) than did all 20 items. The worst-fitting item per domain was recommended for exclusion (Q17, sick days; Q15, financial difficulties; Q14 personal relationships; Q3, nervous, respectively). Whether the same phenomenon is observed in data from younger (< 20y) patients, for whom the questionnaire was originally designed, is not currently known.

Methods This was a cross-sectional evaluation of the SRS-instrument's factor structure and its equivalence across different language versions in young (< 20y) deformity patients. Confirmatory factor analysis was performed on the 20 non-management items of the questionnaire completed by 3440 adolescents with spinal deformity (2746 English-speaking, 206 Spanish, 223 Italian, and 265 German; 70% female; mean age,14.9 ± 2.2 y), to compare the relative fit of the data to a 20-item single-factor structure, a 20-item 4-factor structure, and a 16-item 4-factor structure. Item loading and the goodness of fit were determined from the root mean square error of approximation (RMSEA) and the comparative fit index (CFI). Equivalence of item-loading was compared across languages.

Results Compared with the 20-item version, the 16-item solution significantly increased the fit (p < 0.001) across all language versions, to achieve good model fit (CFI=0.96, RMSE=0.06; Figure 1). For both 16-item and 20-item models, equivalence across languages was not reached, with some items showing weaker item-loading for some languages, in particular the German-language version.

Conclusion Also in patients with adolescent idiopathic scoliosis, the shorter version of the SRS-instrument shows a better fit to the intended 4-factor structure. The wording of some of the items, and/or their equivalence across language versions, may need to be addressed. Questionnaire completion can be a burden for patients; if a shorter, more structurally valid version is available, its use should be encouraged. This shorter version of the SRS-instrument, with removal of ill-fitting items, should deliver more meaningful information on patient-reported outcomes and may also serve to improve compliance with questionnaire completion.
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