Measuring Quality of Life in Adults with Scoliosis: A Cross-Sectional Study Comparing SRS-22 and ISYQOL Questionnaires
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Characteristics
2.2. Data Collection
2.3. Participants
2.4. Sample Size Calculation
2.5. Health-Related Quality-of-Life Questionnaires: SRS-22 and ISYQOL
2.6. Statistical Analysis
2.6.1. Categories’ Functioning
2.6.2. Fit the Model
2.6.3. Dimensionality
2.6.4. Differential Item Functioning
2.6.5. Questionnaire Reliability and Targeting
2.7. Ethical Approval
3. Results
3.1. Rasch Analysis of ISYQOL International
3.2. Rasch Analysis of SRS-22
4. Discussion
Study Limitations and Further Developments
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Methods: The Rasch Analysis of the SRS-22 and ISYQOL International Questionnaires
- 1.
- Categories’ functioning
- 2.
- Fit to the model
- 3.
- Dimensionality
- 4.
- Differential Item Functioning
- 5.
- Targeting and reliability
Appendix B. Supplementary Results
Item | Score | Count Used | Average Measure | Andrich Threshold | |
---|---|---|---|---|---|
Calibration | SE | ||||
1, get worse | 0 | 9 | −1.36 | - | - |
1 | 88 | 1.13 | −2.27 | 0.39 | |
2 | 88 | 3.45 | 2.27 | 0.19 | |
2, worried back pain | 0 | 28 | −0.91 | - | - |
1 | 77 | 0.30 | −1.49 | 0.26 | |
2 | 80 | 2.60 | 1.49 | 0.20 | |
3, big deal | 0 | 89 | −3.03 | - | - |
1 | 77 | −0.50 | −1.64 | 0.20 | |
2 | 19 | 0.71 | 1.64 | 0.29 | |
4, worried not get better | 0 | 47 | −1.82 | - | - |
1 | 76 | 0.21 | −1.30 | 0.22 | |
2 | 62 | 2.01 | 1.30 | 0.21 | |
5, suffering | 0 | 65 | −2.54 | - | - |
1 | 86 | −0.17 | −1.61 | 0.20 | |
2 | 34 | 1.57 | 1.61 | 0.24 | |
6, appearance | 0 | 71 | −2.66 | - | - |
1 | 85 | −0.41 | −1.64 | 0.20 | |
2 | 29 | 1.76 | 1.64 | 0.25 | |
7, worried back problem | 0 | 6 | −0.65 | - | - |
1 | 106 | 1.08 | −2.84 | 0.46 | |
2 | 73 | 3.85 | 2.84 | 0.20 | |
8, bother to show | 0 | 67 | −1.94 | - | - |
1 | 72 | −0.29 | −1.20 | 0.21 | |
2 | 46 | 1.55 | 1.20 | 0.22 | |
9, worried visible | 0 | 58 | −2.35 | - | - |
1 | 92 | −0.18 | −1.74 | 0.21 | |
2 | 35 | 1.60 | 1.74 | 0.24 |
Item | Score | Count Used | Average Measure | Andrich Threshold | |
---|---|---|---|---|---|
Calibration | SE | ||||
1, pain six months | 1 | 3 | −1.69 | - | - |
2 | 37 | 0.08 | −2.74 | 0.63 | |
3 | 50 | 0.53 | 0.13 | 0.21 | |
4 | 56 | 1.44 | 0.88 | 0.18 | |
5 | 53 | 2.21 | 1.73 | 0.19 | |
2, pain last month | 1 | 6 | −0.91 | - | - |
2 | 26 | −0.10 | −1.78 | 0.46 | |
3 | 51 | 0.37 | −0.42 | 0.22 | |
4 | 60 | 1.15 | 0.65 | 0.18 | |
5 | 56 | 2.06 | 1.56 | 0.19 | |
3, nervous person | 1 | 4 | −1.96 | - | - |
2 | 46 | −0.21 | −3.19 | 0.55 | |
3 | 88 | 0.34 | −0.67 | 0.19 | |
4 | 45 | 1.09 | 1.34 | 0.18 | |
5 | 16 | 1.47 | 2.51 | 0.30 | |
4, back shape | 1 | 18 | −1.15 | - | - |
2 | 36 | −0.55 | −1.54 | 0.28 | |
3 | 77 | 0.07 | −1.04 | 0.19 | |
4 | 44 | 0.63 | 0.90 | 0.18 | |
5 | 24 | 1.39 | 1.67 | 0.26 | |
5, activity level | 1 | 26 | 0.10 | - | - |
2 | 63 | 0.40 | −0.54 | 0.23 | |
3 | 110 | 1.68 | 0.54 | 0.16 | |
6, look in clothes | 1 | 5 | −0.89 | - | - |
2 | 19 | −0.67 | −2.12 | 0.50 | |
3 | 94 | 0.28 | −1.69 | 0.24 | |
4 | 65 | 1.02 | 0.97 | 0.17 | |
5 | 16 | 1.73 | 2.85 | 0.29 | |
7, down in the dumps | 1 | 8 | 0.20 | - | - |
2 | 30 | 0.54 | −1.00 | 0.40 | |
3 | 35 | 1.04 | 0.73 | 0.21 | |
4 | 126 | 2.01 | 0.27 (*) | 0.17 | |
8, back pain at rest | 1 | 28 | −0.30 | - | - |
2 | 49 | 0.02 | −0.86 | 0.23 | |
3 | 53 | 0.70 | 0.19 | 0.18 | |
4 | 69 | 1.09 | 0.68 | 0.18 | |
9, work/school | 1 | 15 | −0.07 | - | - |
2 | 26 | 0.47 | −0.43 | 0.31 | |
3 | 37 | 0.77 | 0.30 | 0.21 | |
4 | 120 | 1.73 | 0.12 (*) | 0.17 | |
10, trunk appearance | 1 | 13 | −1.89 | - | - |
2 | 56 | −0.88 | −2.73 | 0.31 | |
3 | 100 | −0.20 | −1.17 | 0.17 | |
4 | 23 | 0.54 | 1.64 | 0.23 | |
5 | 7 | 1.39 | 2.26 | 0.44 | |
11, pain medications | 1 | 2 | 1.97 | - | - |
2 | 38 | 2.01 | −1.25 | 0.77 | |
3 | 159 | 3.20 | 1.25 | 0.19 | |
12, around the house | 1 | 11 | −0.84 | - | - |
2 | 20 | −0.05 | −0.82 | 0.35 | |
3 | 42 | 0.41 | −0.50 | 0.23 | |
4 | 38 | 1.04 | 0.82 | 0.19 | |
5 | 88 | 1.78 | 0.50 (*) | 0.18 | |
13, calm and peaceful | 1 | 21 | −0.89 | - | - |
2 | 57 | −0.32 | −1.70 | 0.26 | |
3 | 98 | 0.36 | −0.56 | 0.17 | |
4 | 23 | 1.04 | 2.26 | 0.25 | |
14, personal relationships | 1 | 5 | −0.38 | - | - |
2 | 11 | 0.05 | −0.78 | 0.52 | |
3 | 26 | 0.67 | −0.34 | 0.31 | |
4 | 42 | 1.15 | 0.51 | 0.21 | |
5 | 115 | 2.12 | 0.62 | 0.17 | |
16, down hearted and blue | 1 | 6 | −0.43 | - | - |
2 | 8 | −0.05 | −0.41 | 0.48 | |
3 | 38 | 0.79 | −1.16 (*) | 0.32 | |
4 | 55 | 1.15 | 0.53 | 0.19 | |
5 | 92 | 1.95 | 1.05 | 0.17 | |
17, days off | 1 | 10 | 0.31 | - | - |
2 | 6 | 0.83 | 0.92 | 0.39 | |
3 | 7 | 1.52 | 0.75 (*) | 0.32 | |
4 | 176 | 1.95 | −1.67 (*) | 0.26 | |
18, going out | 1 | 18 | 0.27 | - | - |
2 | 52 | 0.80 | −0.45 | 0.27 | |
3 | 129 | 1.87 | 0.45 | 0.17 | |
19, feel attractive | 1 | 26 | −1.70 | - | - |
2 | 25 | −1.22 | −1.31 | 0.24 | |
3 | 104 | −0.33 | −2.18 (*) | 0.19 | |
4 | 37 | 0.14 | 0.99 | 0.20 | |
5 | 7 | 1.81 | 2.51 | 0.43 | |
20, happy person | 1 | 15 | −0.84 | - | - |
2 | 65 | −0.38 | −2.16 | 0.29 | |
3 | 100 | 0.40 | −0.40 | 0.17 | |
4 | 19 | 1.52 | 2.56 | 0.27 | |
21, satisfied with results | 1 | 11 | −1.09 | - | - |
2 | 26 | −0.62 | −1.68 | 0.35 | |
3 | 76 | −0.01 | −1.32 | 0.21 | |
4 | 63 | 0.83 | 0.57 | 0.17 | |
5 | 18 | 1.68 | 2.43 | 0.28 | |
22, same management again | 1 | 67 | −0.71 | - | - |
2 | 64 | 0.10 | −0.37 | 0.18 | |
3 | 62 | 0.55 | 0.37 | 0.18 |
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Adults | Adolescents | |
---|---|---|
Males vs. females, N | 30 vs. 120 | 10 vs. 40 |
Mean age (SD), years | 49 (17.8) | 16 (1.4) |
Mean disease severity (SD), °Cobb | 46.2 (16.6) | 24.7 (9) |
Median TRACE score (IQR) | 7 (4) | 5 (3) |
Items | Calibration | SE | Infit | Outfit | ||
---|---|---|---|---|---|---|
MnSq | Z-Std | MnSq | Z-Std | |||
1 (1), get worse | −1.95 | 0.17 | 0.97 | −0.30 | 0.99 | 0.00 |
2 (2), worried back pain | −0.95 | 0.15 | 1.12 | 1.17 | 1.54 | 3.11 |
3 (3), big deal | 1.76 | 0.16 | 1.00 | 0.00 | 0.95 | −0.23 |
4 (4), worried not get better | −0.13 | 0.14 | 1.01 | 0.10 | 1.08 | 0.61 |
5 (7), suffering | 0.85 | 0.15 | 0.93 | −0.64 | 0.84 | −1.22 |
6 (8), appearance | 1.10 | 0.15 | 0.82 | −1.92 | 0.75 | −1.81 |
7 (9), worried back problem | −1.95 | 0.18 | 0.83 | −1.68 | 0.75 | −1.72 |
8 (11), bother to show | 0.59 | 0.14 | 1.25 | 2.31 | 1.24 | 1.53 |
9 (12), worried visible | 0.69 | 0.15 | 1.07 | 0.69 | 1.02 | 0.23 |
Item | Group | Obs − Exp | Bias | SE | p Value |
---|---|---|---|---|---|
ISYQOL International | |||||
8 (11), bother to show | Adolescents | 0.19 | 0.83 | 0.28 | 0.006 |
SRS-22 | |||||
3, nervous person | Older | 0.31 | 0.61 | 0.20 | 0.003 |
4, back shape | Adolescents | −0.46 | 0.68 | 0.17 | 0.000 |
8, back pain at rest | Older | 0.36 | 0.51 | 0.17 | 0.004 |
12, around the house | Adolescents | 0.39 | 1.19 | 0.35 | 0.002 |
Score | Burden of Disease | HRQOL | ||
---|---|---|---|---|
Measure, Logit | SE, Logit | Measure, % | SE, % | |
0 | −6.44 | 1.95 | 100.0 | 16.2 |
1 | −4.89 | 1.24 | 87.1 | 10.3 |
2 | −3.64 | 1.03 | 76.7 | 8.6 |
3 | −2.73 | 0.89 | 69.1 | 7.4 |
4 | −2.04 | 0.78 | 63.3 | 6.5 |
5 | −1.49 | 0.71 | 58.8 | 5.9 |
6 | −1.03 | 0.66 | 54.9 | 5.5 |
7 | −0.61 | 0.63 | 51.4 | 5.3 |
8 | −0.22 | 0.62 | 48.1 | 5.2 |
9 | 0.16 | 0.61 | 45.0 | 5.1 |
10 | 0.54 | 0.61 | 41.9 | 5.1 |
11 | 0.92 | 0.62 | 38.7 | 5.2 |
12 | 1.32 | 0.64 | 35.4 | 5.3 |
13 | 1.73 | 0.66 | 31.9 | 5.5 |
14 | 2.19 | 0.69 | 28.1 | 5.8 |
15 | 2.70 | 0.74 | 23.9 | 6.2 |
16 | 3.32 | 0.84 | 18.7 | 7.0 |
17 | 4.22 | 1.10 | 11.2 | 9.1 |
18 | 5.56 | 1.88 | 0.0 | 15.7 |
Items | Calibration | SE | Infit | Outfit | ||
---|---|---|---|---|---|---|
MnSq | Z-Std | MnSq | Z-Std | |||
1, pain six months | −0.28 | 0.09 | 0.69 | −3.72 | 0.66 | −3.67 |
2, pain last month | −0.15 | 0.09 | 0.75 | −2.83 | 0.71 | −3.06 |
3, nervous person | 0.40 | 0.10 | 1.14 | 1.41 | 1.21 | 2.02 |
4, back shape | 0.70 | 0.09 | 1.09 | 0.96 | 1.10 | 1.00 |
5, activity level | −0.24 | 0.12 | 0.87 | −1.46 | 0.85 | −1.13 |
6, look in clothes | 0.32 | 0.10 | 1.04 | 0.41 | 1.04 | 0.45 |
7, down in the dumps | −0.71 | 0.10 | 0.97 | −0.27 | 1.13 | 0.68 |
8, back pain at rest | 0.30 | 0.09 | 1.42 | 4.07 | 1.52 | 3.90 |
9, work/school | −0.41 | 0.09 | 1.09 | 0.79 | 1.08 | 0.44 |
10, trunk appearance | 1.19 | 0.10 | 1.00 | 0.03 | 1.01 | 0.10 |
11, pain medications | −2.13 | 0.18 | 0.96 | −0.24 | 1.00 | 0.06 |
12, around the house | −0.19 | 0.08 | 0.74 | −2.73 | 0.81 | −1.30 |
13, calm and peaceful | 0.72 | 0.11 | 1.17 | 1.73 | 1.18 | 1.72 |
14, personal relationships | −0.72 | 0.09 | 0.80 | −1.82 | 0.72 | −1.63 |
16, downhearted and blue | −0.52 | 0.09 | 1.09 | 0.83 | 1.08 | 0.64 |
17, days off | −0.99 | 0.12 | 1.35 | 1.67 | 1.80 | 1.21 |
18, going out | −0.61 | 0.13 | 0.89 | −1.10 | 0.98 | −0.07 |
19, feel attractive | 1.29 | 0.09 | 0.97 | −0.22 | 0.91 | −0.84 |
20, happy person | 0.67 | 0.11 | 1.03 | 0.37 | 1.05 | 0.48 |
21, satisfied with results | 0.52 | 0.09 | 0.95 | −0.52 | 0.93 | −0.65 |
22, same management again | 0.84 | 0.11 | 1.20 | 2.26 | 1.24 | 2.01 |
Score | HRQOL | HRQOL | ||
---|---|---|---|---|
Measure, Logit | SE, Logit | Measure, % | SE, % | |
21 | −5.99 | 1.85 | 0.0 | 14.7 |
22 | −4.73 | 1.04 | 10.1 | 8.3 |
23 | −3.96 | 0.75 | 16.2 | 6.0 |
24 | −3.49 | 0.63 | 19.9 | 5.0 |
25 | −3.15 | 0.55 | 22.7 | 4.4 |
26 | −2.88 | 0.50 | 24.8 | 4.0 |
27 | −2.65 | 0.46 | 26.6 | 3.6 |
28 | −2.46 | 0.42 | 28.2 | 3.4 |
29 | −2.29 | 0.40 | 29.5 | 3.2 |
30 | −2.14 | 0.37 | 30.7 | 3.0 |
31 | −2.01 | 0.36 | 31.7 | 2.8 |
32 | −1.89 | 0.34 | 32.7 | 2.7 |
33 | −1.78 | 0.33 | 33.6 | 2.6 |
34 | −1.67 | 0.32 | 34.4 | 2.5 |
35 | −1.58 | 0.31 | 35.2 | 2.4 |
36 | −1.49 | 0.30 | 35.9 | 2.4 |
37 | −1.40 | 0.29 | 36.6 | 2.3 |
38 | −1.32 | 0.28 | 37.2 | 2.3 |
39 | −1.24 | 0.28 | 37.8 | 2.2 |
40 | −1.17 | 0.27 | 38.4 | 2.2 |
41 | −1.10 | 0.27 | 39.0 | 2.1 |
42 | −1.03 | 0.26 | 39.6 | 2.1 |
43 | −0.96 | 0.26 | 40.1 | 2.1 |
44 | −0.89 | 0.26 | 40.7 | 2.1 |
45 | −0.82 | 0.26 | 41.2 | 2.1 |
46 | −0.76 | 0.26 | 41.7 | 2.0 |
47 | −0.69 | 0.25 | 42.2 | 2.0 |
48 | −0.63 | 0.25 | 42.7 | 2.0 |
49 | −0.56 | 0.25 | 43.3 | 2.0 |
50 | −0.50 | 0.25 | 43.8 | 2.0 |
51 | −0.44 | 0.25 | 44.3 | 2.0 |
52 | −0.37 | 0.25 | 44.8 | 2.0 |
53 | −0.31 | 0.26 | 45.3 | 2.0 |
54 | −0.24 | 0.26 | 45.8 | 2.0 |
55 | −0.18 | 0.26 | 46.4 | 2.1 |
56 | −0.11 | 0.26 | 46.9 | 2.1 |
57 | −0.04 | 0.26 | 47.4 | 2.1 |
58 | 0.03 | 0.26 | 48.0 | 2.1 |
59 | 0.10 | 0.26 | 48.5 | 2.1 |
60 | 0.17 | 0.27 | 49.1 | 2.1 |
61 | 0.24 | 0.27 | 49.7 | 2.2 |
62 | 0.31 | 0.27 | 50.2 | 2.2 |
63 | 0.39 | 0.28 | 50.8 | 2.2 |
64 | 0.47 | 0.28 | 51.5 | 2.2 |
65 | 0.54 | 0.28 | 52.1 | 2.3 |
66 | 0.63 | 0.29 | 52.7 | 2.3 |
67 | 0.71 | 0.29 | 53.4 | 2.3 |
68 | 0.80 | 0.30 | 54.1 | 2.4 |
69 | 0.89 | 0.30 | 54.8 | 2.4 |
70 | 0.98 | 0.31 | 55.6 | 2.5 |
71 | 1.08 | 0.32 | 56.4 | 2.5 |
72 | 1.18 | 0.32 | 57.2 | 2.6 |
73 | 1.29 | 0.33 | 58.0 | 2.6 |
74 | 1.40 | 0.34 | 58.9 | 2.7 |
75 | 1.52 | 0.35 | 59.9 | 2.8 |
76 | 1.65 | 0.36 | 60.9 | 2.9 |
77 | 1.78 | 0.37 | 61.9 | 2.9 |
78 | 1.92 | 0.38 | 63.0 | 3.0 |
79 | 2.07 | 0.39 | 64.2 | 3.1 |
80 | 2.22 | 0.40 | 65.5 | 3.2 |
81 | 2.39 | 0.41 | 66.8 | 3.3 |
82 | 2.57 | 0.43 | 68.2 | 3.4 |
83 | 2.76 | 0.44 | 69.7 | 3.5 |
84 | 2.96 | 0.46 | 71.4 | 3.7 |
85 | 3.19 | 0.49 | 73.2 | 3.9 |
86 | 3.44 | 0.52 | 75.2 | 4.1 |
87 | 3.73 | 0.56 | 77.5 | 4.5 |
88 | 4.09 | 0.63 | 80.3 | 5.0 |
89 | 4.56 | 0.75 | 84.1 | 6.0 |
90 | 5.31 | 1.03 | 90.1 | 8.2 |
91 | 6.56 | 1.84 | 100.0 | 14.7 |
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Zaina, F.; Ferrario, I.; Caronni, A.; Scarano, S.; Donzelli, S.; Negrini, S. Measuring Quality of Life in Adults with Scoliosis: A Cross-Sectional Study Comparing SRS-22 and ISYQOL Questionnaires. J. Clin. Med. 2023, 12, 5071. https://doi.org/10.3390/jcm12155071
Zaina F, Ferrario I, Caronni A, Scarano S, Donzelli S, Negrini S. Measuring Quality of Life in Adults with Scoliosis: A Cross-Sectional Study Comparing SRS-22 and ISYQOL Questionnaires. Journal of Clinical Medicine. 2023; 12(15):5071. https://doi.org/10.3390/jcm12155071
Chicago/Turabian StyleZaina, Fabio, Irene Ferrario, Antonio Caronni, Stefano Scarano, Sabrina Donzelli, and Stefano Negrini. 2023. "Measuring Quality of Life in Adults with Scoliosis: A Cross-Sectional Study Comparing SRS-22 and ISYQOL Questionnaires" Journal of Clinical Medicine 12, no. 15: 5071. https://doi.org/10.3390/jcm12155071