Roland-Morris Scale Reliability

Abstract

Letter to the Editor: There is much more research that describes the measurement properties of evaluative measures such as the Roland-Morris (RM) scale1 today than there was a decade ago. The greater volume of studies provides more data that can be used to shape clinical decisions. This increased amount of research also increases the chance that the results of some studies, at times, may conflict with results of other studies. As the number of studies on a particular issue grows, the potential for conflicting results increases. The study of Davidson and Keating2 seems to be an illustration of this phenomenon. Davidson and Keating2 examined the reliability and responsiveness of 5 functional status questionnaires designed for patients with low back pain (LBP). One of the scales examined was the RM scale, a questionnaire that has been studied extensively by our group and many others. Davidson and Keating found that the reliability of RM scale measurements was low, with an intraclass correlation coefficient (ICC [2,1]) of .53 (95% confidence interval [CI]=.29,.71) for a sample of 47 patients with LBP who reported that their LBP was “about the same,” “a little better,” or “a little worse.” For a smaller subgroup that reported their LBP was “about the same,” the ICC (2,1) was lower at .42 (95% CI=−;.07, .75). Based in part on these findings, the authors concluded that the RM scale “appeared to lack sufficient reliability and scale width for clinical application.”2(p8) In our opinion, these results are dramatically different from the large volume of evidence reported in the literature on the reliability of RM scale scores (Table).1,2,6–17 The evidence summarized in the Table was collected on diverse samples of patients from different countries with many different LBP diagnoses. Davidson and …