A Systematic Review of Head-to-Head Comparison Studies of the Roland-Morris and Oswestry Measures' Abilities to Assess Change

Low back pain (LBP) is a common musculoskeletal condition that can lead to pain, functional limitations and disability. Due to the prevalence of LBP, multiple self-reported outcome measures have been developed, which have resulted in redundancy in the literature. Two frequently used outcome measures are the Roland Morris Questionnaire (RMQ) and the Oswestry Disability Index (ODI). Few authors have performed head-to-head comparison studies to determine which of these outcome measures are the most successful at measuring sensitivity to change. The purpose of this thesis was to answer the question: Is there a difference in the sensitivity to change between the RMQ and the ODI in their ability to measure pain-related functional status in persons with low back pain? The first part of this thesis involves a systematic review of head-to-head comparison studies to determine the difference in the sensitivity to change of the RMQ and the ODI. Five databases were searched and nine articles were located. The second part of this thesis entails the development of a quality criteria form to evaluate head-to-head comparison studies. The third aspect of this research was to perform a head-to-head comparison study of the RMQ and the ODI using data from the nine studies. A small but significant difference was noted in favour of the RMQ in terms of the Spearman rank correlation coefficient between its change scores and the reference standard (Z = 2.36, p = 0.018; Z = 3.28, p = 0.001) and also in the Receiver Operating Characteristic curve area (X21 = 8.58, p = 0.003). Master of Science Rehabilitation Science (MSc)