Evidence on the measurement properties of health-related quality of life instruments is largely missing in patients with low back pain, a systematic review

Alessandro Chiarotto, Caroline B. Terwee, Steven J. Kamper, Maarten Boers, Raymond W. Ostelo

Research output: Contribution to journalReview articleAcademicpeer-review


OBJECTIVE: To synthesize the measurement properties of six health-related quality of life (HRQoL) instruments [Short Form 36 (SF-36), Short Form 12 (SF-12), EuroQol 5D-3L (EQ-5D-3L), EuroQol 5D-5L (EQ-5D-5L), Nottingham Health Profile (NHP), PROMIS Global Health (PROMIS-GH-10)] in patients with low back pain (LBP).

STUDY DESIGN AND SETTING: Six electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, SportDiscus, Google Scholar) were searched (July 2017). Studies assessing any measurement property in non-specific LBP patients were included. Two reviewers independently screened articles and assessed risk of bias (COSMIN checklist). Consensus-based criteria were used to rate measurement properties results as sufficient, insufficient or inconsistent; a modified GRADE approach was adopted for evidence synthesis.

RESULTS: High quality evidence was found for insufficient construct validity of SF-36 summary scores and EQ-5D-3L utility and visual analogue scale scores. Moderate evidence was found for inconsistent construct validity of SF-12 physical summary score and inconsistent responsiveness of EQ-5D-3L utility score. Very low quality evidence was found on each instrument content validity; very low to low evidence underpinned the other assessed measurement properties. EQ-5D-5L and PROMIS-GH-10 were not evaluated in LBP patients.

CONCLUSION: Documentation of the measurement properties of HRQoL instruments in LBP is incomplete. Future clinimetric studies should prioritize content validity.

Original languageEnglish
Pages (from-to)23-37
JournalJournal of Clinical Epidemiology
Early online date21 May 2018
Publication statusPublished - Oct 2018

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