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Reliability, Validity, and Responsiveness of the Norwegian Versions of the Maine-Seattle Back Questionnaire and the Sciatica Bothersomeness and Frequency Indices

Grøvle, Lars, MD*; Haugen, Anne Julsrud, MD*; Keller, Anne, MD, PhD; Natvig, Bård, MD, PhD; Brox, Jens Ivar, MD, PhD§¶; Grotle, Margreth, PT, PhD∥**

doi: 10.1097/BRS.0b013e31818047d6
Health Services Research

Study Design. Cross-sectional and prospective study of patients with sciatica and disc herniation.

Objective. To describe the process of translation of the Norwegian versions of the Maine Seattle Back Questionnaire (MSBQ), the Sciatica Bothersomeness Index (SBI) and the Sciatica Frequency Index (SFI), and to test the reliability, construct validity and responsiveness of these Norwegian versions.

Summary of Background Data. The instruments have been validated in English only.

Methods. Reliability was assessed by internal consistency (Cronbach α), test-retest reliability (ICC) and measurement error (MDC and Bland and Altman’s limits of agreement). Construct validity was assessed by comparing the 3 measures with subscales of SF-36, ratings of back and leg pain, and clinical findings. Responsiveness was assessed by standardized response means and Receiver Operating Characteristic curve analyses.

Results. Four hundred sixty six patients were included in the study, of whom 87 participated in the test-retest study. Completion time for the MSBQ was 1–2 minutes and 30 seconds for the SBI and the SFI, respectively. ICCs varied between 0.86 and 0.90. Cronbach α was 0.74, 0.70, and 0.65 for the MSBQ, SBI, and SFI, respectively. The measurement errors constituted 26% of the total MSBQ score range, 22% of the SBI and 27% of the SFI score range. Compared to the MSBQ the 2 Sciatica Indexes discriminated better between patients with normal versus abnormal clinical findings, but correlated less strongly with pain and physical functioning. Responsiveness was assessed by 2 external criteria at 3 months, a global change score (improved vs. unchanged) and surgical treatment status (operated vs. nonoperated). All standardized response means were ≥1.3 and all AUCs ≥0.75. Differences between the 3 measures were generally small.

Conclusion. The Norwegian versions of the MSBQ and the Sciatica Frequency and Bothersomeness Indexes were rapidly administered, with acceptable internal consistency, test-retest reliability, measurement error, construct validity and responsiveness.

The Norwegian versions of the Maine Seattle Back Questionnaire and the Sciatica Bothersomeness and Frequency Indexes were validated in a large patient cohort. All 3 questionnaires demonstrated acceptable reliability, construct validity and responsiveness, supporting their usability in patients with sciatica.

From the *Department of Rheumatology, Østfold Hospital Trust, Norway; †Department of Physical Medicine and Rehabilitation, Division for Neuroscience and Musculoskeletal Medicine, Ullevaal University Hospital, Oslo; ‡Section of Occupational Health and Social Insurance Medicine, Institute of General Practice and Community Health, University of Oslo, Oslo; §Section for Back Surgery and Physical Medicine and Rehabilitation, Department of Orthopaedics, Rikshospitalet University Hospital, Oslo. ¶Unifob Health, University of Bergen, Bergen, Norway; ∥FORMI (Communication Unit for Musculoskeletal Disorders), Division for Neuroscience and Musculoskeletal Medicine, Ullevaal University Hospital, Oslo; and **National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo.

Acknowledgment date: October 19, 2007. First revision date: March 4, 2008. Second revision date: May 3, 2008. Acceptance date: May 5, 2008.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Institutional funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Supported by a grant from the Eastern Norway Regional Health Authority.

The study protocol was approved by the Regional Committee for Medical Research Ethics, Oslo (October 11, 2004) and The Ombudsman for Privacy in Research at the Norwegian Social Science Data Services (March 2, 2005).

Address correspondence and reprint requests to Lars Grøvle, MD, Revmatologisk avdeling, Sykehuset Østfold, 1702 Sarpsborg, Norway; E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.