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Open Access 24-04-2025 | Neck Pain | Research

Responsiveness and minimal important change of neck disability index and numeric pain rating scale for neck patients in the Norwegian neck and back register

Authors: Bjørneboe John, Cecilie Røe, Jens Ivar Brox, Håkon Sveinall, Janica Ignatius, Maja Wilhelmsen, Sigrid Skatteboe

Published in: European Spine Journal

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Abstract

Purpose

To evaluate the responsiveness and the minimal important change (MIC) of Neck Disability Index (NDI) and pain during activity by the numeric rating scale (NRSa) in the Norwegian neck and back registry (NNRR).

Materials and methods

Participants with neck pain responding to baseline, 6 and 12-months follow-up in the NNRR were included. Responsiveness was calculated using the area under the receiver operating characteristic (ROC). The minimal important change (MIC) was calculated with an anchor-based method and distribution-based methods. For the anchor-based method we used the Patient Global Impression of Change (PGIC) as the anchor. The PGIC was on a 7-point Likert scale, and trichotomized into three ordinal categories.

Results

A total of 551 patients with neck pain were included. Among these patients, 60% were women with an average age of 48, and 63% had experienced neck pain for more than one year. For improved patients NDI and NRSa had adequate responsiveness at both follow-ups. MIC calculations using an anchor-based method were more accurate than those using a distribution-based method, which fell below the measurement error for the instruments. Using anchor-based calculation of MIC, the MIC for NDI was 17 at the 6-months follow-up and 9 at 12-months follow-up. Correspondingly, NRSa had a MIC of 2.5 at both follow-ups.

Conclusion

NDI and NRSa were responsive at both 6-months and 12-months follow-up and can be used in registries following patients with neck pain over time.
Literature
1.
go back to reference Bot SD, van der Waal JM, Terwee CB, van der Windt DA, Schellevis FG, Bouter LM, Dekker J (2005) Incidence and prevalence of complaints of the neck and upper extremity in general practice. Ann Rheum Dis 64(1):118–123CrossRefPubMedPubMedCentral Bot SD, van der Waal JM, Terwee CB, van der Windt DA, Schellevis FG, Bouter LM, Dekker J (2005) Incidence and prevalence of complaints of the neck and upper extremity in general practice. Ann Rheum Dis 64(1):118–123CrossRefPubMedPubMedCentral
2.
go back to reference Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396(10258):1204–22 Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396(10258):1204–22
3.
go back to reference Safiri S, Kolahi AA, Hoy D, Buchbinder R, Mansournia MA, Bettampadi D et al (2020) Global, regional, and national burden of neck pain in the general population, 1990–2017: systematic analysis of the Global Burden of Disease Study 2017. BMJ 368:m791CrossRefPubMedPubMedCentral Safiri S, Kolahi AA, Hoy D, Buchbinder R, Mansournia MA, Bettampadi D et al (2020) Global, regional, and national burden of neck pain in the general population, 1990–2017: systematic analysis of the Global Burden of Disease Study 2017. BMJ 368:m791CrossRefPubMedPubMedCentral
4.
go back to reference Chang EM, Gillespie EF, Shaverdian N (2019) Truthfulness in patient-reported outcomes: factors affecting patients’ responses and impact on data quality. Patient Relat Outcome Meas 10:171–186CrossRefPubMedPubMedCentral Chang EM, Gillespie EF, Shaverdian N (2019) Truthfulness in patient-reported outcomes: factors affecting patients’ responses and impact on data quality. Patient Relat Outcome Meas 10:171–186CrossRefPubMedPubMedCentral
5.
go back to reference de Vet HCW TC, Mokkink LB, Knol DL (2011) Responsiveness. Measurement in medicine: a practical guide. Cambridge: Cambridge University Press de Vet HCW TC, Mokkink LB, Knol DL (2011) Responsiveness. Measurement in medicine: a practical guide. Cambridge: Cambridge University Press
6.
go back to reference Johansen JB, Roe C, Bakke E, Mengshoel AM, Andelic N (2014) Reliability and responsiveness of the Norwegian version of the neck disability index. Scand J Pain 5(1):28–33CrossRefPubMed Johansen JB, Roe C, Bakke E, Mengshoel AM, Andelic N (2014) Reliability and responsiveness of the Norwegian version of the neck disability index. Scand J Pain 5(1):28–33CrossRefPubMed
7.
go back to reference Johansen JB, Andelic N, Bakke E, Holter EB, Mengshoel AM, Roe C (2013) Measurement properties of the Norwegian version of the neck disability index in chronic neck pain. Spine (Phila Pa 1976) 38(10):851–856CrossRefPubMed Johansen JB, Andelic N, Bakke E, Holter EB, Mengshoel AM, Roe C (2013) Measurement properties of the Norwegian version of the neck disability index in chronic neck pain. Spine (Phila Pa 1976) 38(10):851–856CrossRefPubMed
8.
go back to reference Terwee CB, Peipert JD, Chapman R, Lai JS, Terluin B, Cella D et al (2021) Minimal important change (MIC): a conceptual clarification and systematic review of MIC estimates of PROMIS measures. Qual Life Res 30(10):2729–2754CrossRefPubMedPubMedCentral Terwee CB, Peipert JD, Chapman R, Lai JS, Terluin B, Cella D et al (2021) Minimal important change (MIC): a conceptual clarification and systematic review of MIC estimates of PROMIS measures. Qual Life Res 30(10):2729–2754CrossRefPubMedPubMedCentral
9.
go back to reference Heide M, Mørk M, Fenne Hoksrud A, Brox JI, Røe C (2023) Responsiveness of specific and generic patient-reported outcome measures in patients with plantar fasciopathy. Disabil Rehabil 1–7 Heide M, Mørk M, Fenne Hoksrud A, Brox JI, Røe C (2023) Responsiveness of specific and generic patient-reported outcome measures in patients with plantar fasciopathy. Disabil Rehabil 1–7
10.
go back to reference Copay AG, Eyberg B, Chung AS, Zurcher KS, Chutkan N, Spangehl MJ (2018) Minimum clinically important difference: current trends in the orthopaedic literature, part II: lower extremity: a systematic review. JBJS Rev 6(9):e2CrossRefPubMed Copay AG, Eyberg B, Chung AS, Zurcher KS, Chutkan N, Spangehl MJ (2018) Minimum clinically important difference: current trends in the orthopaedic literature, part II: lower extremity: a systematic review. JBJS Rev 6(9):e2CrossRefPubMed
11.
go back to reference Bjørneboe J, Bratsberg A, Brox JI, Skatteboe S, Wilhelmsen M, Samuelsen KM et al (2024) Symptom burden and follow-up of patients with neck and back complaints in specialized outpatient care: a national register study. Sci Rep 14(1):3855CrossRefPubMedPubMedCentral Bjørneboe J, Bratsberg A, Brox JI, Skatteboe S, Wilhelmsen M, Samuelsen KM et al (2024) Symptom burden and follow-up of patients with neck and back complaints in specialized outpatient care: a national register study. Sci Rep 14(1):3855CrossRefPubMedPubMedCentral
12.
go back to reference Aars NA, Brandseth O, Bardal I, Stevelink S, Sanatkar S, Trichet LO et al (2025) Cohort profile: the Norwegian neck and back registry (NNRR): a medical quality registry for patients with neck and back complaints. BMJ Open 15(3):e096992CrossRefPubMedPubMedCentral Aars NA, Brandseth O, Bardal I, Stevelink S, Sanatkar S, Trichet LO et al (2025) Cohort profile: the Norwegian neck and back registry (NNRR): a medical quality registry for patients with neck and back complaints. BMJ Open 15(3):e096992CrossRefPubMedPubMedCentral
13.
go back to reference Seymour RA (1982) The use of pain scales in assessing the efficacy of analgesics in post-operative dental pain. Eur J Clin Pharmacol 23(5):441–444CrossRefPubMed Seymour RA (1982) The use of pain scales in assessing the efficacy of analgesics in post-operative dental pain. Eur J Clin Pharmacol 23(5):441–444CrossRefPubMed
14.
go back to reference Grotle M, Brox JI, Vollestad NK (2003) Cross-cultural adaptation of the Norwegian versions of the Roland-Morris disability questionnaire and the Oswestry disability index. J Rehabil Med 35(5):241–247CrossRefPubMed Grotle M, Brox JI, Vollestad NK (2003) Cross-cultural adaptation of the Norwegian versions of the Roland-Morris disability questionnaire and the Oswestry disability index. J Rehabil Med 35(5):241–247CrossRefPubMed
15.
go back to reference Roland M, Fairbank J (2000) The Roland-Morris disability questionnaire and the Oswestry disability questionnaire. Spine (Phila Pa 1976) 25(24):3115–3124CrossRefPubMed Roland M, Fairbank J (2000) The Roland-Morris disability questionnaire and the Oswestry disability questionnaire. Spine (Phila Pa 1976) 25(24):3115–3124CrossRefPubMed
16.
go back to reference Vernon H, Mior S (1991) The neck disability index: a study of reliability and validity. J Manipulative Physiol Ther 14(7):409–415PubMed Vernon H, Mior S (1991) The neck disability index: a study of reliability and validity. J Manipulative Physiol Ther 14(7):409–415PubMed
17.
go back to reference Kamper SJ, Maher CG, Mackay G (2009) Global rating of change scales: a review of strengths and weaknesses and considerations for design. J Man Manip Ther 17(3):163–170CrossRefPubMedPubMedCentral Kamper SJ, Maher CG, Mackay G (2009) Global rating of change scales: a review of strengths and weaknesses and considerations for design. J Man Manip Ther 17(3):163–170CrossRefPubMedPubMedCentral
18.
go back to reference Devji T, Carrasco-Labra A, Qasim A, Phillips M, Johnston BC, Devasenapathy N et al (2020) Evaluating the credibility of anchor based estimates of minimal important differences for patient reported outcomes: instrument development and reliability study. BMJ 369:m1714CrossRefPubMedPubMedCentral Devji T, Carrasco-Labra A, Qasim A, Phillips M, Johnston BC, Devasenapathy N et al (2020) Evaluating the credibility of anchor based estimates of minimal important differences for patient reported outcomes: instrument development and reliability study. BMJ 369:m1714CrossRefPubMedPubMedCentral
19.
go back to reference De Vet HCW TC, Mokkink LB, Knol DL (2011) Interpretability. Measurement in medicine: a practical guide. Cambridge: Cambridge University Press 227–74 De Vet HCW TC, Mokkink LB, Knol DL (2011) Interpretability. Measurement in medicine: a practical guide. Cambridge: Cambridge University Press 227–74
20.
go back to reference Wang Y, Devji T, Carrasco-Labra A, King MT, Terluin B, Terwee CB et al (2023) A step-by-step approach for selecting an optimal minimal important difference. BMJ 381:e073822CrossRefPubMed Wang Y, Devji T, Carrasco-Labra A, King MT, Terluin B, Terwee CB et al (2023) A step-by-step approach for selecting an optimal minimal important difference. BMJ 381:e073822CrossRefPubMed
21.
go back to reference Norman GR, Sloan JA, Wyrwich KW (2003) Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 41(5):582–592CrossRefPubMed Norman GR, Sloan JA, Wyrwich KW (2003) Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 41(5):582–592CrossRefPubMed
22.
go back to reference Samsa G, Edelman D, Rothman ML, Williams GR, Lipscomb J, Matchar D (1999) Determining clinically important differences in health status measures: a general approach with illustration to the health utilities index mark II. Pharmacoeconomics 15(2):141–155CrossRefPubMed Samsa G, Edelman D, Rothman ML, Williams GR, Lipscomb J, Matchar D (1999) Determining clinically important differences in health status measures: a general approach with illustration to the health utilities index mark II. Pharmacoeconomics 15(2):141–155CrossRefPubMed
23.
go back to reference Bobos P, MacDermid JC, Walton DM, Gross A, Santaguida PL (2018) Patient-reported outcome measures used for neck disorders: an overview of systematic reviews. J Orthop Sports Phys Ther 48(10):775–788CrossRefPubMed Bobos P, MacDermid JC, Walton DM, Gross A, Santaguida PL (2018) Patient-reported outcome measures used for neck disorders: an overview of systematic reviews. J Orthop Sports Phys Ther 48(10):775–788CrossRefPubMed
24.
go back to reference Saltychev M, Pylkas K, Karklins A, Juhola J (2024) Psychometric properties of neck disability index - a systematic review and meta-analysis. Disabil Rehabil 1–17 Saltychev M, Pylkas K, Karklins A, Juhola J (2024) Psychometric properties of neck disability index - a systematic review and meta-analysis. Disabil Rehabil 1–17
25.
go back to reference Cleland JA, Childs JD, Whitman JM (2008) Psychometric properties of the neck disability index and numeric pain rating scale in patients with mechanical neck pain. Arch Phys Med Rehabil 89(1):69–74CrossRefPubMed Cleland JA, Childs JD, Whitman JM (2008) Psychometric properties of the neck disability index and numeric pain rating scale in patients with mechanical neck pain. Arch Phys Med Rehabil 89(1):69–74CrossRefPubMed
26.
go back to reference Young IA, Dunning J, Butts R, Mourad F, Cleland JA (2019) Reliability, construct validity, and responsiveness of the neck disability index and numeric pain rating scale in patients with mechanical neck pain without upper extremity symptoms. Physiother Theory Pract 35(12):1328–1335CrossRefPubMed Young IA, Dunning J, Butts R, Mourad F, Cleland JA (2019) Reliability, construct validity, and responsiveness of the neck disability index and numeric pain rating scale in patients with mechanical neck pain without upper extremity symptoms. Physiother Theory Pract 35(12):1328–1335CrossRefPubMed
27.
go back to reference Young BA, Walker MJ, Strunce JB, Boyles RE, Whitman JM, Childs JD (2009) Responsiveness of the neck disability index in patients with mechanical neck disorders. Spine J 9(10):802–808CrossRefPubMed Young BA, Walker MJ, Strunce JB, Boyles RE, Whitman JM, Childs JD (2009) Responsiveness of the neck disability index in patients with mechanical neck disorders. Spine J 9(10):802–808CrossRefPubMed
28.
go back to reference Monticone M, Ambrosini E, Vernon H, Brunati R, Rocca B, Foti C, Ferrante S (2015) Responsiveness and minimal important changes for the neck disability index and the neck pain disability scale in Italian subjects with chronic neck pain. Eur Spine J 24(12):2821–2827CrossRefPubMed Monticone M, Ambrosini E, Vernon H, Brunati R, Rocca B, Foti C, Ferrante S (2015) Responsiveness and minimal important changes for the neck disability index and the neck pain disability scale in Italian subjects with chronic neck pain. Eur Spine J 24(12):2821–2827CrossRefPubMed
29.
go back to reference Langenfeld A, Gassner AP, Wirth B, Mühlemann MB, Nyirö L, Bastiaenen C, Swanenburg J (2022) Responsiveness of the German version of the neck disability index in chronic neck pain patients: a prospective cohort study with a seven-week follow-up. Arch Physiother 12(1):23CrossRefPubMedPubMedCentral Langenfeld A, Gassner AP, Wirth B, Mühlemann MB, Nyirö L, Bastiaenen C, Swanenburg J (2022) Responsiveness of the German version of the neck disability index in chronic neck pain patients: a prospective cohort study with a seven-week follow-up. Arch Physiother 12(1):23CrossRefPubMedPubMedCentral
30.
go back to reference Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M et al (2008) Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976) 33(1):90–94CrossRefPubMed Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M et al (2008) Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976) 33(1):90–94CrossRefPubMed
32.
go back to reference Braten LCH, Grovle L, Wigemyr M, Wilhelmsen M, Gjefsen E, Espeland A et al (2022) Minimal important change was on the lower spectrum of previous estimates and responsiveness was sufficient for core outcomes in chronic low back pain. J Clin Epidemiol 151:75–87CrossRefPubMed Braten LCH, Grovle L, Wigemyr M, Wilhelmsen M, Gjefsen E, Espeland A et al (2022) Minimal important change was on the lower spectrum of previous estimates and responsiveness was sufficient for core outcomes in chronic low back pain. J Clin Epidemiol 151:75–87CrossRefPubMed
33.
go back to reference King MT (2011) A point of minimal important difference (MID): a critique of terminology and methods. Expert Rev Pharmacoecon Outcomes Res 11(2):171–184CrossRefPubMed King MT (2011) A point of minimal important difference (MID): a critique of terminology and methods. Expert Rev Pharmacoecon Outcomes Res 11(2):171–184CrossRefPubMed
34.
go back to reference Grøvle L, Haugen AJ, Hasvik E, Natvig B, Brox JI, Grotle M (2014) Patients’ ratings of global perceived change during 2 years were strongly influenced by the current health status. J Clin Epidemiol 67(5):508–515CrossRefPubMed Grøvle L, Haugen AJ, Hasvik E, Natvig B, Brox JI, Grotle M (2014) Patients’ ratings of global perceived change during 2 years were strongly influenced by the current health status. J Clin Epidemiol 67(5):508–515CrossRefPubMed
35.
go back to reference Gagnier JJ, Lai J, Mokkink LB, Terwee CB (2021) COSMIN reporting guideline for studies on measurement properties of patient-reported outcome measures. Qual Life Res 30(8):2197–2218CrossRefPubMed Gagnier JJ, Lai J, Mokkink LB, Terwee CB (2021) COSMIN reporting guideline for studies on measurement properties of patient-reported outcome measures. Qual Life Res 30(8):2197–2218CrossRefPubMed
36.
go back to reference Franceschini M, Boffa A, Pignotti E, Andriolo L, Zaffagnini S, Filardo G (2023) The minimal clinically important difference changes greatly based on the different calculation methods. Am J Sports Med 51(4):1067–1073CrossRefPubMedPubMedCentral Franceschini M, Boffa A, Pignotti E, Andriolo L, Zaffagnini S, Filardo G (2023) The minimal clinically important difference changes greatly based on the different calculation methods. Am J Sports Med 51(4):1067–1073CrossRefPubMedPubMedCentral
Metadata
Title
Responsiveness and minimal important change of neck disability index and numeric pain rating scale for neck patients in the Norwegian neck and back register
Authors
Bjørneboe John
Cecilie Røe
Jens Ivar Brox
Håkon Sveinall
Janica Ignatius
Maja Wilhelmsen
Sigrid Skatteboe
Publication date
24-04-2025
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-025-08836-7