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Jumbo SU1,2, Macdermid JC3,4,5, Kalu ME5, Packham TL5, Athwal GS4, Faber KJ4
1University of Western Ontario, School of Health and Rehabilition Sciences, London, Canada, 2Lily Hospitals Limited, Lily Wellness Centre, Warri, Nigeria, 3University of Western Ontario, School of Physical Therapy, London, Canada, 4St. Joseph's Healthcare, Roth McFarlane Hand and Upper Limb Centre, London, Canada, 5McMaster University, School of Rehabilitation Science, Hamilton, Canada
Background: The BPI-SF and SF-MPQ-2 are general-use, self-report, multidimensional pain assessment outcomes that are more frequently used for pain assessment in musculoskeletal (MSK) conditions. Synthesizing knowledge on their measurement properties, as assessed in MSK condition, should provide a deeper understanding of their strengths and limitations.
Purpose: To systematically locate, critically appraise, compare and summarize clinical measurement research addressing the use of BPI-SF and SF-MPQ-2 in pain-related musculoskeletal conditions.
Methods: Four databases (Medline, CINAHL, EMBASE & SCOPUS) were systematically searched for relevant citations, each for the BPI-SF and SF-MPQ-2. We included articles that reported on psychometric properties (e.g validity, reliability, responsiveness) and interpretability indices (e.g minimal clinical important difference [MCID]) of both tools, as assessed in mixed and specific MSK studies. Independently, two reviewers extracted data, assessed for risk of bias, rated, and synthesized the quality of studies according to the updated COSMIN methodology (Version-10).
Results: Twenty-four articles were included (BPI-SF, n=17; SF-MPQ-2, n=7). Both tools lack report on their cross-cultural validities and measurement error indices (standard error of measurement [SEM] and minimal detectable change [MDC]). High quality studies suggest that they are internal consistent (α = 0.83-0.96), and they associate modestly with similar outcome measures (r = 0.3-0.69). There is evidence that the BPI-SF conforms to its two-dimensional structure in MSK studies; the SF-MPQ-2 four-factor structure was not clearly established. In seven reports, high to moderate quality evidence was seen in supports of the BPI-SF known group validity (n=2) and responsiveness (n=5) but none was available for the SF-MPQ-2. Furthermore, the SF-MPQ-2 was more frequently associated with floor effects in MSK studies than the BPI-SF (SF-MPQ-2, 42% vs BPI-SF, 6%).
Conclusion(s): Although the SF-MPQ-2 presents potentials, and both tools displayed high-quality evidence in support of their internal consistency and criterion-convergent validities, high to moderate quality evidence suggests that the BPI-SF subscales have better responsiveness, retest reliability, known group validity and structural validities than the SF-MPQ-2. Therefore, the BPI-SF is currently better for pain assessment in MSK conditions. However, high-quality studies are needed on some of the measurement properties of both tools including their cross-cultural validities, retest reliability, error indices (SEM & MDC), minimal clinical important difference (MCID) and clinical important difference (CID).
Implications: If the qualities/characteristic of pain is not the primary focus of the patient´s assessment, researchers and clinicians should first consider using the BPI-SF for pain assessment in musculoskeletal conditions over the SF-MPQ-2.
Keywords: musculoskeletal conditions, patient reported ouctome, systematic review
Funding acknowledgements: Joy C. MacDermid, Ph.D. was supported by the Dr. James Roth Chair in Musculoskeletal Measurement and Knowledge Translation.
Purpose: To systematically locate, critically appraise, compare and summarize clinical measurement research addressing the use of BPI-SF and SF-MPQ-2 in pain-related musculoskeletal conditions.
Methods: Four databases (Medline, CINAHL, EMBASE & SCOPUS) were systematically searched for relevant citations, each for the BPI-SF and SF-MPQ-2. We included articles that reported on psychometric properties (e.g validity, reliability, responsiveness) and interpretability indices (e.g minimal clinical important difference [MCID]) of both tools, as assessed in mixed and specific MSK studies. Independently, two reviewers extracted data, assessed for risk of bias, rated, and synthesized the quality of studies according to the updated COSMIN methodology (Version-10).
Results: Twenty-four articles were included (BPI-SF, n=17; SF-MPQ-2, n=7). Both tools lack report on their cross-cultural validities and measurement error indices (standard error of measurement [SEM] and minimal detectable change [MDC]). High quality studies suggest that they are internal consistent (α = 0.83-0.96), and they associate modestly with similar outcome measures (r = 0.3-0.69). There is evidence that the BPI-SF conforms to its two-dimensional structure in MSK studies; the SF-MPQ-2 four-factor structure was not clearly established. In seven reports, high to moderate quality evidence was seen in supports of the BPI-SF known group validity (n=2) and responsiveness (n=5) but none was available for the SF-MPQ-2. Furthermore, the SF-MPQ-2 was more frequently associated with floor effects in MSK studies than the BPI-SF (SF-MPQ-2, 42% vs BPI-SF, 6%).
Conclusion(s): Although the SF-MPQ-2 presents potentials, and both tools displayed high-quality evidence in support of their internal consistency and criterion-convergent validities, high to moderate quality evidence suggests that the BPI-SF subscales have better responsiveness, retest reliability, known group validity and structural validities than the SF-MPQ-2. Therefore, the BPI-SF is currently better for pain assessment in MSK conditions. However, high-quality studies are needed on some of the measurement properties of both tools including their cross-cultural validities, retest reliability, error indices (SEM & MDC), minimal clinical important difference (MCID) and clinical important difference (CID).
Implications: If the qualities/characteristic of pain is not the primary focus of the patient´s assessment, researchers and clinicians should first consider using the BPI-SF for pain assessment in musculoskeletal conditions over the SF-MPQ-2.
Keywords: musculoskeletal conditions, patient reported ouctome, systematic review
Funding acknowledgements: Joy C. MacDermid, Ph.D. was supported by the Dr. James Roth Chair in Musculoskeletal Measurement and Knowledge Translation.
Topic: Outcome measurement; Musculoskeletal; Pain & pain management
Ethics approval required: No
Institution: Not applicable
Ethics committee: Not applicable
Reason not required: This work is a systematic review of outcome measures; ethical approval is not required to conduct such research.
All authors, affiliations and abstracts have been published as submitted.
