Confirmatory factory analysis of the Neck Disability Index in a general problematic neck population indicates a one-factor model

Background context The Neck Disability Index frequently is used to measure outcomes of the neck. The statistical rigor of the Neck Disability Index has been assessed with conflicting outcomes. To date, Confirmatory Factor Analysis of the Neck Disability Index has not been reported for a suitably lar...

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Main Authors: Gabel, C., Cuesta-Vargas, A., Osborne, J., Burkett, B., Melloh, Markus
Format: Journal Article
Published: Elsevier Inc. 2014
Online Access:http://hdl.handle.net/20.500.11937/41191
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author Gabel, C.
Cuesta-Vargas, A.
Osborne, J.
Burkett, B.
Melloh, Markus
author_facet Gabel, C.
Cuesta-Vargas, A.
Osborne, J.
Burkett, B.
Melloh, Markus
author_sort Gabel, C.
building Curtin Institutional Repository
collection Online Access
description Background context The Neck Disability Index frequently is used to measure outcomes of the neck. The statistical rigor of the Neck Disability Index has been assessed with conflicting outcomes. To date, Confirmatory Factor Analysis of the Neck Disability Index has not been reported for a suitably large population study. Because the Neck Disability Index is not a condition-specific measure of neck function, initial Confirmatory Factor Analysis should consider problematic neck patients as a homogenous group. Purpose We sought to analyze the factor structure of the Neck Disability Index through Confirmatory Factor Analysis in a symptomatic, homogeneous, neck population, with respect to pooled populations and gender subgroups. Study design This was a secondary analysis of pooled data. Patient sample A total of 1,278 symptomatic neck patients (67.5% female, median age 41 years), 803 nonspecific and 475 with whiplash-associated disorder. Outcome measures The Neck Disability Index was used to measure outcomes. Methods We analyzed pooled baseline data from six independent studies of patients with neck problems who completed Neck Disability Index questionnaires at baseline. The Confirmatory Factor Analysis was considered in three scenarios: the full sample and separate sexes. Models were compared empirically for best fit. Results Two-factor models have good psychometric properties across both the pooled and sex subgroups. However, according to these analyses, the one-factor solution is preferable from both a statistical perspective and parsimony. The two-factor model was close to significant for the male subgroup (p<.07) where questions separated into constructs of mental function (pain, reading headaches and concentration) and physical function (personal care, lifting, work, driving, sleep, and recreation). Conclusions The Neck Disability Index demonstrated a one-factor structure when analyzed by Confirmatory Factor Analysis in a pooled, homogenous sample of neck problem patients. However, a two-factor model did approach significance for male subjects where questions separated into constructs of mental and physical function. Further investigations in different conditions, subgroup and sex-specific populations are warranted. © 2014 Elsevier Inc. All rights reserved.
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spelling curtin-20.500.11937-411912017-09-13T14:09:28Z Confirmatory factory analysis of the Neck Disability Index in a general problematic neck population indicates a one-factor model Gabel, C. Cuesta-Vargas, A. Osborne, J. Burkett, B. Melloh, Markus Background context The Neck Disability Index frequently is used to measure outcomes of the neck. The statistical rigor of the Neck Disability Index has been assessed with conflicting outcomes. To date, Confirmatory Factor Analysis of the Neck Disability Index has not been reported for a suitably large population study. Because the Neck Disability Index is not a condition-specific measure of neck function, initial Confirmatory Factor Analysis should consider problematic neck patients as a homogenous group. Purpose We sought to analyze the factor structure of the Neck Disability Index through Confirmatory Factor Analysis in a symptomatic, homogeneous, neck population, with respect to pooled populations and gender subgroups. Study design This was a secondary analysis of pooled data. Patient sample A total of 1,278 symptomatic neck patients (67.5% female, median age 41 years), 803 nonspecific and 475 with whiplash-associated disorder. Outcome measures The Neck Disability Index was used to measure outcomes. Methods We analyzed pooled baseline data from six independent studies of patients with neck problems who completed Neck Disability Index questionnaires at baseline. The Confirmatory Factor Analysis was considered in three scenarios: the full sample and separate sexes. Models were compared empirically for best fit. Results Two-factor models have good psychometric properties across both the pooled and sex subgroups. However, according to these analyses, the one-factor solution is preferable from both a statistical perspective and parsimony. The two-factor model was close to significant for the male subgroup (p<.07) where questions separated into constructs of mental function (pain, reading headaches and concentration) and physical function (personal care, lifting, work, driving, sleep, and recreation). Conclusions The Neck Disability Index demonstrated a one-factor structure when analyzed by Confirmatory Factor Analysis in a pooled, homogenous sample of neck problem patients. However, a two-factor model did approach significance for male subjects where questions separated into constructs of mental and physical function. Further investigations in different conditions, subgroup and sex-specific populations are warranted. © 2014 Elsevier Inc. All rights reserved. 2014 Journal Article http://hdl.handle.net/20.500.11937/41191 10.1016/j.spinee.2013.08.026 Elsevier Inc. restricted
spellingShingle Gabel, C.
Cuesta-Vargas, A.
Osborne, J.
Burkett, B.
Melloh, Markus
Confirmatory factory analysis of the Neck Disability Index in a general problematic neck population indicates a one-factor model
title Confirmatory factory analysis of the Neck Disability Index in a general problematic neck population indicates a one-factor model
title_full Confirmatory factory analysis of the Neck Disability Index in a general problematic neck population indicates a one-factor model
title_fullStr Confirmatory factory analysis of the Neck Disability Index in a general problematic neck population indicates a one-factor model
title_full_unstemmed Confirmatory factory analysis of the Neck Disability Index in a general problematic neck population indicates a one-factor model
title_short Confirmatory factory analysis of the Neck Disability Index in a general problematic neck population indicates a one-factor model
title_sort confirmatory factory analysis of the neck disability index in a general problematic neck population indicates a one-factor model
url http://hdl.handle.net/20.500.11937/41191