• Amit Jain, Virginie Lafage, Michael P Kelly, Hamid Hassanzadeh, Brian J Neuman, Daniel M Sciubba, Shay Bess, Christopher I Shaffrey, Christopher P Ames, Justin K Scheer, Douglas Burton, Munish C Gupta, Robert Hart, Richard A Hostin, Khaled M Kebaish, and International Spine Study Group.
• *Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD †Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY ‡Department of Orthopaedic Surgery, Washington University, St. Louis, MO §Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA ¶Department of Neurosurgery, The Johns Hopkins University, Baltimore, MD **Rocky Mountain Scoliosis and Spine, Rocky Mountain Hospital for Children and Presbyterian St. Luke's Medical Center, Denver, CO ††University of Virginia Health System, Charlottesville, VA ‡‡University of California San Francisco, San Francisco, CA §§University of California San Diego, San Diego, CA ¶¶Department of Orthopaedic Surgery, University of Kansas, Kansas City, KS ***Department of Orthopedics, Washington University, St. Louis, MO †††Department of Orthopaedic Surgery, Oregon Health and Science University, Portland, OR ‡‡‡Southwest Scoliosis Institute, Plano, TX §§§The International Spine Study Group Foundation, Denver, CO.
• Spine. 2016 Sep 15; 41 (18): 1463-8.

Study DesignA retrospective analysis.ObjectiveThe aim of our study was to compare the normality, concurrent validity, internal consistency, responsiveness, and dimensionality of an item response theory-derived seven-question instrument (SRS-7), against the Scoliosis Research Society-22r (SRS-22r) questionnaire in operatively treated patients with adult spinal deformity (ASD).Summary Of Background DataCompared with SRS-22r, SRS-7 (which has been validated in operatively treated patients with adolescent idiopathic scoliosis) has advantages of being short, unidimensional, and linear.MethodsA prospective database of ASD patients was queried for patients 18 years or older who were operatively treated, and who answered pre- and postoperative (at 2-year follow-up) SRS-22r questions (n = 276). Corresponding SRS-7 scores were calculated using answers to SRS-22r items 1, 4, 6, 10, 18, 19, and 20. Significance was set at a P value less than 0.01.ResultsSRS-7 and SRS-22r were normally distributed preoperatively but not postoperatively. SRS-7 and SRS-22r scores had high correlation both preoperatively (r = 0.76, P < 0.01) and postoperatively (r = 0.83, P < 0.01). The internal consistency reliability Cronbach α values were 0.61 (SRS-7) and 0.83 (SRS-22r) preoperatively and 0.91 (SRS-7) and 0.95 (SRS-22r) postoperatively. SRS-7 was found to be more responsive than SRS-22r with measures of effect size: Cohen d = 1.21 versus 1.13, Hedge g = 1.21 versus 1.13, and effect size correlation r = 0.52 versus 0.49. Iterative principal factor analysis of pre- and postoperative scores showed the presence of one dominant latent factor in SRS-7 (unidimensionality) and four latent factors in SRS-22r (multidimensionality).ConclusionSRS-7 is a valid, reliable, responsive, and unidimensional instrument, which can be used as a short-form alternative to the SRS-22r for assessing global changes in patient-reported outcomes over time in patients with ASD.Level Of Evidence3.

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