In our rehabilitation facility, we use the Oswestry Disability Index (ODI) to measure before and after results of treatment. I’ve been thinking that if the final goal is to get workers back on-the-job, is the ODI really the best tool to use for this particular outcome measure? Have you seen any studies on this?

There was a recent study from the PRIDE Research Foundation in Dallas Texas. They evaluated both the Oswestry Disability Index (ODI) and the Short Form-36 (SF-36) in relation to work retention (getting back to work).

As you probably know, when using these assessment tools, the minimum clinical important difference (MCID) is evaluated. The MCID is defined as “the smallest change or difference in results that is beneficial and leads to a change in how the patient is treated.”

For those who are not familiar with what that means — rehab specialists need assessment tools that actually measure an important change (or amount of change) as a result of treatment. If these commonly used tests don’t give that information, then the time it takes to administer the test and calculate the results just isn’t worth it.

As it turns out, neither the Oswestry Disability Index nor the Short Form-36 measured the amount of change that would predict employment a year after treatment. More than three-fourths of the group (77 per cent) in the study did get back to work.

There were enough success stories that if the measuring tools were going to be predictive, they would have shown some type of minimum clinical important difference (MCID). But they didn’t because what they were measuring wasn’t linked with the final outcome of getting back to work.

So you may be onto something with your question — it’s a question others have asked and are actively studying. More study is needed to find a way to predict individual patient improvement that will lead to a return-to-work status as the final outcome.