Affiliations: [a] School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada | [b] Research Centre of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
Correspondence:
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Corresponding author: Yannick Tousignant-Laflamme, School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke J1H 5N4, QC, Canada. E-mail: [email protected].
Abstract: BACKGROUND: A framework to establish the biopsychosocial patient profile for persons with low back pain has been recently proposed and validated: The Pain and Disability Drivers Management model (PDDM). In order to facilitate its clinical integration, we developed the PDDM rating scale. OBJECTIVES: To determine the inter-rater agreement of the PDDM rating scale. A second objective was to determine if this inter-rater agreement varies according to the complexity of patients’ clinical presentation. METHODS: We recruited physiotherapists during one-day workshops on the PDDM. We asked each participant to assess two clinical vignettes using the rating scale. One vignette presented a typical clinical presentation (moderate level of difficulty) and one presented an atypical presentation (complex level of difficulty). We determined inter-rater agreement with the proportion of participants who gave the same answer for each PDDM domain. RESULTS: For the typical vignette, the inter-rater agreement per domain was moderate to good (between 0.54 and 0.97). For the complex vignette, the inter-rater agreement per domain was poor to good (between 0.49 and 0.81). The comparison between the two vignettes showed a significant difference (p< 0.01) for nociceptive and cognitive-emotional domains. CONCLUSION: Overall performance indicates that the rating scale present adequate agreement for clinical use, but specific domains require further development.
Keywords: Low back pain, phenotype, rehabilitation, scale development, biopsychosocial, patient-centered care
