Establishing the biopsyschosocial profile of people who suffer with low back pain: Development, content validity and inter-rater agreement of a rating scale based on the Pain and Disability Drivers Management model
Year: 2021
Type: dissertation
Abstract: Background: Establishing the biopsychosocial profile of people with low back pain (LBP) is an essential step to personalize care. The Pain and Disability Drivers Management model (PDDM) has been proposed in order to establish this profile. This model includes five domains containing elements that are drivers of pain and\or disability. Each domain includes two categories of severity. The development of a clinical tool to establish this profile would facilitate the integration of the model in clinical practice. The objectives of this project are: 1) To develop a rating scale in order to rapidly establish the patient profile and to validate its content. 2) To estimate the inter-rater agreement of this scale. Methods: The first objective consisted of three steps: 1) Item generation from a comprehensive literature review, 2) Scale refinement according to the participants’ feedback, and 3) Statistical analyses to assess the content validity. To validate each item, we used Item level-Content Validity Index (I-CVI) with a 0.78 threshold for three criteria: clarity, presentation, and clinical applicability of the item. To validate the overall scale, we performed an Average-Content Validity Index (Ave-CVI) with a 0.9 threshold. For the second objective, the recruited physiotherapists used the newly developed scale to establish the profile from two clinical vignettes. The first vignette presented a typical clinical presentation of low back pain and the second one presented an atypical presentation. We used the proportion of agreement per domain of each vignette to determine the inter-rater agreements. Results: For the first objective, we developed a 5 item-rating scale with four scoring options. A total of 42 participants were recruited and allowed refining the scale. The statistical analyses of the latter version allowed validating the content of the scale. We observed, for each item, the I-CVI of the three criteria presented results above the threshold (between 0.94 and 1.0). For the overall scale, the result (Ave-CVI=0.95) supports its validation. For the second objective, we recruited 72 physiotherapists. For the two vignettes, the inter-rater agreements were poor to good. Conclusion: We developed and validated the content of the first scale in order to establish the biopsychosocial profile based on the PDDM for people who suffer with LBP. The inter-rater agreement of this scale is poor to good in a sample of physiotherapists newly trained on the model.
Author: Naye, Florian
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7201934176