• Imke Boekel, Alisa L Dutmer, Henrica R Schiphorst Preuper, and Michiel F Reneman.
• Faculty of Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
• Eur Spine J. 2022 Apr 1; 31 (4): 943-952.

PurposeA cross-sectional and longitudinal study was conducted to analyse construct validity, responsiveness, and Minimal Clinically Important Change (MCIC) in the Work Ability Score (WAS) and Pain Disability Index Work item (PDI-W) in patients with Chronic Low Back Pain (CLBP).MethodConstruct validity was assessed by testing predefined hypotheses. Responsiveness and MCIC were measured with an anchor-based method. The area under the receiver Operating Characteristic Curve (AUC) and the optimal cut-off point were calculated. Smallest Detectable Change (SDC) was calculated to determine measurement error.ResultsIn total, 1502 patients (age 18-65 years) with CLBP were included. For validity of the WAS and PDI-W, respectively, seven and six out of 10 hypotheses were not rejected. The WAS (n = 355) was responsive to change with an AUC of 0.70. MCIC was 1.5 point, SDCindividual 4.9, and SDCgroup 0.3. MCICs were 4.5, 1.5, and - 0.5 points for, respectively, low, middle, and high scoring baseline groups. The PDI-W (n = 297) was responsive to change with an AUC of 0.80. MCIC was - 2.5 points, SDCindividual 5.2, and SDCgroup 0.3. MCICs were - 0.5, - 2.5, and - 4.5 points for, respectively, low, middle, and high scoring baseline groups.ConclusionConstruct validity of the WAS and PDI-W was insufficient in this patient sample. The WAS and PDI-W are responsive to change. On average, improvements of 1.5 point (WAS) and  - 2.5 points (PDI-W) were interpreted as clinically important. However, MCICs are also baseline dependent. Due to a risk of measurement error, at the individual level change scores should be interpreted with caution.© 2022. The Author(s).

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