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PubMedDate not supplied

The revised estimated survival probability index of trauma severity.

The construction of a revised version of the Estimated Survival Probability Index (or ESP index) is described. The original index had been proposed as a tool that would be useful in grading from hospital medical records the severity of injuries sustained by patients hospitalized with trauma conditions. The revised index (RESP) is based on a data set of 61,419 records. Unlike the ESP, the RESP index is based upon parameters that are age specific and specific to decimal ICDA codes. The RESP is validated by correlating RESP scores with observed mortality by using an independent set of multiple-trauma patients. Overall, a strong monotonic relationship between the RESP index and increasing mortality was demonstrated. Also, the RESP index correlated with mortality in selected subsets of multiple trauma patients with extremely severe injuries. Some uses and limitations of this index are discussed.

Adult↗
PubMed1980

ADL status in stroke: relative merits of three standard indexes.

Independence in activities of daily living (ADL) in 148 Framingham Study stroke survivors was scored using 3 standard indexes--the Katz Index of ADL, the Barthel Index, and the Kenny Self-Care Evaluation. Complete independence was designated in 35.1% by the Barthel Index, 39.2% by the Katz Index of ADL, and 41.9% by the Kenny Self-Care Evaluation. These differences in frequency are not statistically significant. There is also a high degree of agreement between the scores derived by the 3 indexes as measured by the Kappa Coefficient of Agreement ands the Spearman Rang-Order Correlation Coefficient. In general, each index adequately classifies stroke survivors as dependent or independent. Of the 3, the Barthel Index appears to possess certain advantages which include completeness, sensitivity to change, amenability to statistical manipulation, and greater familiarity due to more widespread use.

Activities of Daily Living↗
PubMedDate not supplied

[The siphonal index of Culex pipiens mosquito larvae (Diptera: Culicidae) from Russia and adjacent countries: its variability and use for the diagnosis of forms].

In 70 natural populations and laboratory strains of Culex pipiens from the former Soviet Union (32 settlements, 37-62 N, 38-93 degrees E) the larval siphonal index was studied, in 29 populations the adult biological peculiarities (the autogeny, the stenogramy and the bloodsucking activity on the human) were studied also in the laboratory. The individual siphonal index varies considerably from 2.2 to 7.9 and has the normal distribution shape. The mean index is correlated with the larval biotope (open or underground reservoirs) and with biological peculiarities. In autogenous and stenogamous populations the mean siphonal index varies from 3.7 to 4.6 (average 4.1), in nonautogenous and eurigamous ones--from 4.7 to 5.6 (average 5.1). The biological mechanisms which provide the differentiation and isolation of the forms C. p. pipiens and C. p. molestus in the temperate zone are discussed. These mechanisms include the capacity to diapause, the ability to copulate in the restricted space (stenogamy), and the biotopic specialization of the larvae (open or underground reservoirs). The individual variation of siphonal index is often too high, therefore the identification of the individual larvae is unreliable. However, the mean siphonal index of the population can be recommended for the identification of the forms in populations from the temperate latitudes: in C. p. molestus the mean siphonal index is 4.3 and lower, in C. p. pipiens it is 4.8 and higher, the rare populations with the intermediate indexes require the additional biological study.

Animals↗
PubMed1993

Amniotic fluid index in hospitalized hypertensive patients managed expectantly.

OBJECTIVE: To determine the relationship between low amniotic fluid (AF) index and fetal growth retardation (FGR), fetal distress, and cesarean delivery in patients hospitalized for hypertensive disease, and to describe changes in AF status in relation to the severity of maternal disease. METHODS: The AF index in 142 hospitalized hypertensive patients was followed per an inpatient protocol with semi-weekly testing; medical records were reviewed to obtain delivery data. RESULTS: Fetal growth retardation was significantly associated with an AF index of 5.0 cm or less or 7.0 cm or less (P < .001) at initial assessment, with positive predictive values of 86 and 52%, respectively. However, the sensitivity of an AF index of 5.0 cm or less or 7.0 cm or less to detect FGR was limited (21 and 46%, respectively). Fetal distress and cesarean delivery were not associated with an AF index of 5.0 cm or less or 7.0 cm or less throughout observation in this cohort. Based upon a definition of oligohydramnios as an AF index of 7.0 cm or less, the AF status worsened from an initial normal value in 39% of patients whose final diagnosis was severe preeclampsia, versus only 14% of patients who were diagnosed as having mild disease. The AF index also normalized in ten patients who were originally diagnosed with oligohydramnios and admitted for expectant management. Only one of these women was diagnosed with severe preeclampsia. CONCLUSIONS: 1) Depending on the definition, the incidence of oligohydramnios ranges from 10-30% in hypertensive patients requiring hospitalization; 2) an AF index of 5.0 cm or less at initial evaluation predicts FGR but lacks sensitivity; 3) the AF status frequently changes with serial assessment, and these changes appear to be related to the severity of hypertensive disease; and 4) the frequency of the obstetric complications studied depends more upon the severity of hypertensive disease than on its potential effect of inducing oligohydramnios.

Cesarean Section↗
PubMed1995

A canine model for determination of the therapeutic index of cytokine inhibitors.

Using tumor necrosis factor (TNF) inhibition in dog blood as a measure of efficacy, and canine emesis as a measure of toxicity, we were able to assign a therapeutic index to rolipram, a prototypic anti-inflammatory compound. Because both assays were performed in the same species, the ambiguities associated with comparing the physiologic effects of drugs on various species was avoided. Rolipram, a standard phosphodiesterase type IV inhibitor, was a prototypic test compound characterized by a number of cardiovascular and central nervous system side effects, as well as its in vitro and in vivo inhibition of TNF. Initial experiments with canine whole blood incubated with lipopolysaccharide resulted in nanogram-per-milliliter concentrations of TNF that could be significantly reduced by in vitro addition of a 0.03 microM concentration of rolipram. Because rolipram inhibited canine TNF production in vitro, a protocol was devised in which TNF inhibitory activity was measured in a series of blood samples from dogs infused with increasingly high doses of rolipram. This yielded the efficacy half of the therapeutic index, whereas the emetogenic dose represented the side effect portion of the index. Rolipram was infused stepwise into conscious dogs at gradually increasing doses. The infusion was stopped when vomiting occurred, and the cumulative dose was reported as the emetic dose. Rolipram caused emesis in dogs at a cumulative dose of 0.1 mg/kg. At each dose of rolipram, blood was collected. The whole blood was incubated in vitro with lipopolysaccharide to induce TNF production, which in turn was quantified by the L929 bio-assay. Theoretically, if the rolipram infusion raised blood values high enough, the rolipram in whole blood would inhibit TNF production and be reflected by a lack of TNF activity in the L929 assay. In this assay system, rolipram's 50% effective dose in the TNF assay was always at least 33-fold lower than its emetic dose of 0.1 mg/kg. This gave rolipram a therapeutic index of at least 33:1 (0.003 versus 0.1 mg/kg) on the basis of its activity in a canine efficacy model (TNF inhibition) and a toxicity model (emesis induction). Experimental compounds were tested for their emetic dose as well as TNF 50% effective dose, with the goal of obtaining a therapeutic index better than that of rolipram. Thus the coupling of cytokine activity with overt toxicity was used to arrive at the therapeutic index of a compound. The therapeutic index was used to rank compounds as to their efficacy/toxicity profile. This ranking was used to eliminate several anti-inflammatory compounds that had a therapeutic index less than that of rolipram.

Animals↗
PubMedDate not supplied

Renal resistive index and left ventricular hypertrophy in essential hypertension: a close link.

The aim of this study was to evaluate renal Doppler resistive index in patients with mild to moderate essential hypertension (EH) and to correlate its changes with the presence of left ventricular hypertrophy assessed by echocardiography. Twenty-eight EH patients (19 males, 9 females, mean age 56.2 +/- 8.6 years) and 13 normotensive subjects (7 males, 6 females, mean age 57.6 +/- 7.9 years) were studied; all patients underwent a complete echocardiographic study (M-mode, two-dimensional and Doppler) and a color Doppler echography of renal and intrarenal arteries. After the renal Doppler waveform was obtained, resistive index was calculated by peak systolic velocity (S) and lowest diastolic velocity (D) with the formula S-D/S. EH patients were divided into two subgroups on the basis of left ventricular mass (LVM): Group EH1 with normal LVM (15 patients) and Group EH2 with increased LVM (13 patients). All patients evidenced normal renal morphology and function and received no therapy throughout the entire observation period. Renal resistive index was significantly higher in EH patients than in controls; however, the maximum difference was observed between normotensive subjects and the EH patients with increased LVM (p < 0.00001). At univariate analysis, significant correlations were found between renal resistive index and age, body mass index, left ventricular relative wall thickness and LVM. However, when multiple regression analysis was used, only age (p < 0.01) and LVM (p < 0.05) remained significant predictors of resistive index. In conclusion, our data show that in EH patients resistive index, which is considered an expression of arterial impedance, is well correlated with the presence of left ventricular hypertrophy, presently considered the best index of the severity of hypertensive disease. This correlation may be the expression of the involvement of two target organs in hypertension.

Adult↗
PubMed1998

An assessment of the comprehension of the American Urological Association Symptom Index.

PURPOSE: We determine the reading grade level of the American Urological Association (AUA) symptom index, and assessed patient ability to read and understand the index using a standardized reading and IQ test. MATERIALS AND METHODS: The reading grade level required to read and understand the AUA symptom index was determined using the Spache and Dale-Chall readability formulas. A total of 202 men a mean of 66.1 years old completed the AUA symptom index, Wonderlic personnel test and scholastic level examination, and revised Ohio literacy test. Patients were instructed to report any difficulty in reading or understanding the AUA symptom score. RESULTS: According to the Spache and Dale-Chall readability formulas, the AUA symptom index requires a grade 6 reading level. Of the 202 patients 30 (14.9%) did not complete the symptom index due to an inability to read it (28, 13.9%) and poor comprehension (2, 1%). Tested mean IQ and reading grade level was 91.7 and 11, respectively. CONCLUSIONS: A grade 6 reading level is required to read and understand the AUA symptom index. A significant percentage of patients cannot read the index and require assistance from others for its completion. This assistance may introduce significant interviewer bias, potentially altering study outcome.

Aged↗
PubMed2006

Dietary glycemic index of human immunodeficiency virus-positive men with and without fat deposition.

This study focused on dietary glycemic index because insulin resistance can be important in the pathogenesis of fat deposition in human immunodeficiency virus (HIV). We evaluated differences in past dietary glycemic intake between men with HIV who developed fat deposition and those who did not. This was a nested case-control study consisting of 37 cases and 37 controls from the Nutrition for Healthy Living cohort. Food records from 6 to 24 months prior to development of fat deposition in cases were analyzed and compared with controls. Cases were defined as men with a waist-to-hip ratio >0.95 and body mass index (calculated as kg/m(2)) between 23 and 26. Controls were matched by age, race, body mass index, highly active antiretroviral therapy use, and CD4 count. Food records were analyzed using t tests for normally distributed nutrients and Wilcoxon rank-sum tests for nutrients with skewed distributions. Glycemic index was calculated for each meal and day. There was no significant difference in glycemic index for meals and day between participants with or without fat deposition. Both groups had a moderate dietary glycemic index intake. This study showed no association between dietary glycemic index and development of fat deposition in HIV. Instead, results of this study depict the potential benefits associated with eating high-quality diets, primarily adequate fiber and protein intake. Diet can be important in preventing development of fat deposition in patients with HIV.

Adiposity↗
PubMed2006

The BODE index after lung volume reduction surgery correlates with survival.

STUDY OBJECTIVE: A recently introduced, multidimensional index called BODE (body mass index [BMI], degree of airflow obstruction assessed by spirometry, grade of dyspnea, and exercise capacity), quantified by 6-min walking distance (6MWD), has excellent predictive power with respect to outcome in COPD. We investigated whether the BODE index is able to predict survival after lung volume reduction surgery (LVRS). DESIGN: Retrospective study. SETTING: Tertiary university hospital. PATIENTS: One hundred eight-six COPD patients (76 women) with severe emphysema (mean +/- SD age, 64 +/- 8 years; mean FEV(1), 28 +/- 8% of predicted). INTERVENTION: Bilateral thoracoscopic LVRS. MEASUREMENTS AND RESULTS: BMI, pulmonary function, 6MWD, and the modified Medical Research Council dyspnea score were assessed before and 3 months after LVRS, and the BODE index was calculated. The patients were followed up with respect to survival for a median time of 40 months (range, 3 to 116 months) after surgery. The mean BODE index decreased from 7.2 +/- 1.6 preoperatively to 4.0 +/- 2.0 at 3 months after LVRS (p < 0.001). The postoperative but not the preoperative BODE correlated with survival, although preoperative patient characteristics were comparable between short-term (< 5 years) and long-term (> 5 years) survivors. A decrease to a lower BODE score class was associated with a reduced mortality (hazard ratio, 0.497, 95% confidence interval, 0.375 to 0.659; p < 0.001). The C statistic for the ability of the BODE index to predict the risk of death was larger (0.74) than that for the FEV(1) (0.63), the degree of dyspnea (0.64), or the 6MWD (0.62). CONCLUSIONS: The postoperative BODE index is a powerful predictor of survival in COPD patients after LVRS.

Aged↗
PubMed1994

Birth weight-length ratios, ponderal indexes, placental weights, and birth weight-placenta ratios in a large population.

BACKGROUND: Birth weight (BW)/length ratios, ponderal indexes, placental weights, and BW/placental weight ratios have been correlated with perinatal morbidity and mortality. METHODS: Cross-sectional survey of live-born, structurally normal, singleton neonates delivered at a tertiary care center in Detroit, Mich, from 1984 through 1991. Subjects were included if dating based on menstrual dates and ultrasonographic estimations agreed with Ballard examination to within 2 weeks. RESULTS: Of 33,138 neonates, 26,983 (81.4%) were black. While all indexes significantly increased with advancing gestational age, only placental weights (without prior draining of blood, blotting the placenta dry, or trimming the membranes or cord) and BW/length ratios significantly increased beyond 40 weeks' gestation. Multivariate analysis of variance revealed that placental weights, BW/placenta ratios, and BW/length ratios were significantly related to gender and ethnicity, but ponderal index was not. Placental weights were larger, and BW/placenta ratios were smaller than studies that trimmed the placentas before weighing. CONCLUSIONS: All indexes were gestational age dependent, but ponderal index and BW/placenta ratios do not increase beyond 40 weeks' gestation. Except for ponderal index, interpretation of these indexes should be specific for ethnicity, gender, and manner of placental preparation.

Birth Weight↗
PubMed1993

Prognostic significance of the proliferation index in surgically resected non-small-cell lung cancer.

OBJECTIVE: To determine the utility of measuring the tumor proliferation index as a prognostic marker in patients with non-small-cell lung cancer. DESIGN: Immunostaining for the proliferation-associated antigen Ki-67, quantitated using computer-assisted image cytometry, was used to derive the tumor proliferation index for 61 fresh-frozen, banked specimens of non-small-cell lung cancer. DNA ploidy was measured concomitantly for all specimens. A median follow-up of 38 months was achieved for survival analyses. SETTING: A large southeastern United States private referral institution and affiliated hospital provided the study environment. PARTICIPANTS: A consecutive, convenience sample of 61 patients was enrolled based on resected tissue preservation and viability over a five-year accruement. MAIN OUTCOME MEASURES: Significant associations between DNA content, proliferation index, established clinicopathological parameters, and outcome were examined. RESULTS: A significant inverse association between patient survival and tumor proliferation index was found that was independent of other established clinicopathological predictors of outcome. Patients whose tumors harbored a proliferation index of less than 3.5 survived significantly longer than patients with tumors demonstrating higher values. No association between DNA content and proliferation index was uncovered. CONCLUSION: Measurement of the proliferation index, as derived from quantitative Ki-67 immunostaining and analyzed by image cytometry, may provide significant complementary, if not independent, prognostic information for patients with non-small-cell lung cancer.

Aged↗
PubMed1992

Composite index of skeletal mass: principal components analysis of regional bone mineral densities.

Principal components analysis is a statistical method that is used to reduce and explore data to facilitate further analyses. This method was applied to bone mineral densities measured at seven sites in 109 black and 44 white women, ages 22-80, at an internal medicine clinic in urban Detroit. We excluded subjects with a history of diseases or drugs known to affect bone metabolism. Principal components analysis was used to summarize the interrelationship of the densities and yielded two major results. First, the seven site measurements were reduced to a single, composite index (PC1) of skeletal mass that accounted for 73% of the variation in density among subjects. PC1 had roughly equal weights among the sites. A second combination of the seven sites indicated that the contrast between axial and appendicular regional densities accounted for another 10% of the variation among subjects. In investigating the relationship of density to age, body mass index, and ethnic group, we found that the principal components composite index had a stronger correlation with age (r = -0.58) and with body mass index (r = 0.34) than almost all of the regional densities. Black-white differences were larger for the composite index than for any single site density. A multiple regression of the composite index on ethnicity, body mass index, and age yielded a larger R2 (0.46) than any of the individual site densities. The second principal component, although of theoretical interest, showed a minimal ability to discriminate among subjects using the three independent variables of this study.

Absorptiometry, Photon↗
PubMed1993

Indexes of obesity and all-causes mortality in Italian epidemiological data.

BACKGROUND: The relationships of body mass index and skinfold thickness to all-causes mortality during a 10-year follow-up were assessed in 8,341 men and 1,100 women ages 30-69 years from different Italian population samples. RESULTS: Among men, both univariate and multivariate analyses showed a clear-cut parabolic (inverse J-shaped) relationship, whose left branch became less steep after the exclusion of smokers, people carrying severe diseases at entry, those who died during the first 5 years, or all of them. The minimum risk was almost always located around 28 units of body mass index, and it decreased to smaller levels of body mass index when the exclusions were adopted. The analysis of skinfold thickness showed similar but less clear-cut results. Among women, due to the limited number of fatal events, the analysis was unable to show any clear relationship of body mass index or skinfold thickness to all-causes mortality. The multivariate analysis showed a similar parabolic relationship of body mass index to all-causes mortality. The estimated multivariate risk of death broken down into five quintiles was unrelated to the mean level of body mass index for each quintile. From the multivariate model it was estimated that an excess of 10 kg in body weight (above the body mass index corresponding to the minimum risk level and everything else being equal) carries the same excess of risk produced by 5 mm Hg of systolic blood pressure or by less than 5 cigarettes smoked per day. CONCLUSION: These results suggest that high levels of obesity indicators are only slightly associated with an excess mortality and that overweight and obesity are health hazards only if they are accompanied by an elevation of other risk factors, mainly of blood pressure.

Adult↗
PubMed1988

Outcome prediction in critically ill patients by means of oxygen consumption index and simplified acute physiology score.

Both oxygen consumption index (VO2-index) and simplified acute physiology score (SAPS) are reported to be reliable predictors of the ultimate outcome in critically ill patients. The purpose of this study was to verify whether survivors and nonsurvivors have different VO2-indices and whether the prognostic potency of SAPS can be improved by addition of VO2-index as a supplemental physiological variable. In 50 mechanically ventilated surgical ICU patients with heterogeneous underlying diseases, SAPS was calculated and VO2-index was determined by continuous 24-h measurement of oxygen consumption. The VO2-indices of survivors and nonsurvivors were not significantly different (p greater than 0.05), which is in contrast to the results of earlier studies. This contrast may be explained by a difference both in methods of VO2-measurement and in study populations. SAPS was significantly lower in survivors than in nonsurvivors (p less than 0.005) and was able to classify the patients correctly into groups of increasing probability of death. However, SAPS failed to be a helpful prognosticator in the individual patient. The addition of VO2-index to SAPS as a supplemental physiological variable did not substantially improve the prognostic potency. Because a higher VO2-index did not necessarily indicate a better survival chance, there is no argument for therapeutic interventions aimed exclusively at increasing VO2-index, as suggested previously.

Adolescent↗
PubMed1993

Comparison of AUA symptom index in unselected males and females between fifty-five and seventy-nine years of age.

A symptom index for benign prostatic hyperplasia (BPH) was recently developed and validated by the Multidisciplinary Measurements Committee of the American Urologic Association, Inc. (AUA). The AUA symptom index ascertains the severity of seven nonspecific urinary symptoms associated with clinical BPH. The objective of the present study was to determine the influence of aging and gender on the AUA symptom index. Approximately 750 individuals attended a health fair at Froedtert Memorial Lutheran Hospital which included exhibits related to surgical and medical disease processes affecting the aging population. A nurse specialist randomly invited male and female attendees to complete the self-administered AUA symptom index and two additional inquiries related to age and gender. A total of 101 males and 96 females between fifty-five and seventy-nine years of age completed the AUA symptom index. The mean age of the males and females completing the AUA symptom index was 69.3 +/- 0.5 years and 68.2 +/- 0.6 years, respectively (p = 0.14). The mean AUA symptom scores in the male and female groups were 6.7 +/- 0.5 and 7.5 +/- 0.6, respectively. The difference between the mean AUA symptom scores in the male and female groups was not statistically significant (p = 0.35). The differences between AUA symptom scores were also not significantly different between males and females in five consecutive advancing-age groups between fifty-five and seventy-nine years of age. The percentage of males with mild, moderate, and severe symptoms was 64 percent, 32 percent, and 4 percent, respectively. The percentage of females with mild, moderate, and severe symptoms was 61 percent, 35 percent, and 4 percent, respectively. The present study suggests that prostatism-like symptoms are a manifestation of aging, and that the AUA symptom index is not BPH-specific.

Age Factors↗
PubMed1995

Predictive validity of the Nursing Severity Index in patients with musculoskeletal disease. Nurses of University Hospitals of Cleveland.

Prior studies have not examined the validity of severity of illness instruments in patients at low risk for mortality. We, therefore, examined the predictive validity of a newly developed instrument, the Nursing Severity Index in 5347 adult medical and surgical patients with musculoskeletal diagnoses admitted to an academic medical center in 1985-88. The Index is based on aggregating 34 clinical observations which were recorded by primary nurses during patient care; observations reflect biologic, functional, cognitive and psychosocial abnormalities. Other data, including patient demographic data and outcomes were obtained from hospital data bases. We found that, among all study patients, admission Nursing Severity Index scores were highly related (p < 0.001) to in-hospital death rates-which were 0, 0.4, 0.8, 2.6, 6.7 and 23.5% in six hierarchical strata defined by the Index-and to nursing home discharge rates. In multivariate analyses, adjusting for diagnosis and other important covariates, each strata was associated with a 2.5-fold increased risk of mortality and a 1.6-fold increased risk of nursing home discharge. In addition, the Nursing Severity Index was an independent predictor (p < 0.001) of hospital charges and length of stay. We conclude that the Nursing Severity Index assesses multiple dimensions of illness, can be easily recorded during routine patient care, and accurately predicts hospital outcomes in an important 'low risk' group of patients. The validity of the Nursing Severity Index in other clinical subgroups should be further studied.

Adult↗
PubMed2005

Eligibility for publicly funded orthodontic treatment determined by the handicapping labiolingual deviation index.

INTRODUCTION: Access to orthodontic care for Medicaid patients has been limited, in part because of orthodontists' reluctance to treat severe malocclusions for low reimbursements. Limited orthodontic treatment in the mixed dentition (phase 1 treatment) has been proposed to address this issue, because the intent of phase 1 treatment is to improve or prevent severe malocclusions. Orthodontists might be more willing to provide shorter, simpler treatment. The purpose of this study was to determine whether phase 1 treatment would reduce malocclusion severity to the extent that eligibility for subsequent Medicaid-funded treatment was significantly reduced. METHODS: Eligibility was determined by the handicapping labiolingual deviation (HLD) index, which is used by several states for this purpose. Eligibility was also determined with the index of complexity, outcome, and need (ICON). This allowed us to compare these 2 indexes. Pre-phase 1 and post-phase 1 index scores were calculated by using study casts from 193 patients treated at the University of Washington orthodontic clinic and the Odessa Brown Children's Dental Clinic, both in Seattle. RESULTS: Using the HLD index, we found that eligibility for orthodontic treatment decreased by 62% after phase 1 treatment. This change was statistically significant at P < .0001. The ICON found significantly more treatment need before phase 1 (90%) than did the HLD index (35%) (P < .0001). CONCLUSIONS: Early interceptive treatment significantly reduces eligibility for comprehensive Medicaid-funded orthodontic treatment. The HLD index is a useful tool for determining Medicaid eligibility.

Adolescent↗
PubMed2005

[The Oswestry index for low back pain translated into Arabic and validated in a Arab population].

OBJECTIVE: To translate into Arabic and validate the Oswestry index for low back pain in an Arab population. BACKGROUND: No functional disability index to assess low back pain written in the Arabic language and validated in an Arab population is available. DESIGN: Arabic translation of the Oswestry index was obtained by the "forward translation/backward translation" method. Adaptations were made after a pilot study involving ten patients aged 18 to 65 years old. Impairment outcome measures (pain as measured on a visual analog scale [VAS], Schober-McRae, index, duration of morning stiffness and number of night awakenings), disability (Quebec index, Waddell index), handicap (as measured on a VAS) and Beck depression scale scores were recorded. Inter-rater reliability was assessed by use of the intra-class correlation coefficient (ICC) and the Bland and Altman method. Construct validity was investigated with use of the Spearman rank correlation coefficient (convergent and divergent validity), and factor analysis was performed. Internal consistency was assessed by use of the Cronbach alpha coefficient. RESULTS: Eighty Tunisian patients with low back pain were included in the validation study. Two items were excluded. Inter-rater reliability was excellent (ICC = 0.98). Expected divergent and convergent validity results suggested good construct validity. Two main factors were extracted by factor analysis and explained 58.19% of the cumulative variance: the first factor represented discomfort in dynamic activities, the second discomfort in static activities. The Cronbach alpha coefficient was 0.76 for factor 1 and 0.70 for factor 2. CONCLUSION: We translated into and adapted the Oswestry index for the Arabic language in a population of Tunisian women? with low back pain. The 8-item version is reliable and valid. Although the scale was validated in a Tunisian population, we expect that it is suitable for other Arab populations, especially North Africans. Further study is needed to confirm such a hypothesis.

Adolescent↗