Demographic factors affect Scoliosis Research Society-22 performance in healthy adolescents: a comparative baseline for adolescents with idiopathic scoliosis

• Published in: Spine (Philadelphia, Pa. 1976) Vol. 35; no. 24; p. 2134
• Main Authors: Verma, Kushagra, Lonner, Baron, Hoashi, Jane S, Lafage, Virginie, Dean, Laura, Engel, Itzhak, Goldstein, Yael
• Format: Journal Article
• Language: English
• Published: United States 15.11.2010
• Subjects: Adolescent; Analysis of Variance; Child; Cultural Characteristics; European Continental Ancestry Group; Family Characteristics; Female; Humans; Income; Male; New York City; Predictive Value of Tests; Prospective Studies; Reference Values; Scoliosis - diagnosis; Scoliosis - ethnology; Scoliosis - physiopathology; Scoliosis - psychology; Severity of Illness Index; Sex Factors; Societies, Medical; Surveys and Questionnaires; Young Adult; New York City
• ISSN: 1528-1159
• DOI: 10.1097/BRS.0b013e3181cb474f

Prospective analysis. The purpose of this study was to: (1) evaluate the influence of variable demographic factors on the Scoliosis Research Society (SRS)-22 performance and (2) evaluate SRS-22 performance in normal adolescents without scoliosis to establish a comparative baseline for adolescent idiopathic scoliosis. The SRS-22 instrument has been used widely to evaluate patients with scoliosis but no study has characterized how variable patient demographics in normal, unaffected individuals may influence SRS-22 scores. Healthy adolescents at a high school clinic and at referring pediatricians' private offices were asked to anonymously complete the SRS-22 instrument: 22 questions scaled 1-5 (highest). Additional questions assessed household income, race (white, Hispanic, African-American, other), gender, household status (single vs. dual parent), and body mass index. ANOVA and multivariate regression analyses were used to identify statistically significant factors (P < 0.05). Four hundred fifty unaffected adolescents completed the SRS-22 (62% female, 38% male; mean age 16 (range, 9.3-21.8), mean body mass index 22.8 (range, 13.5-47.5). Mean SRS-22 performance was 4.1 ± 0.5 (Activity: 4.0 ± 0.6; Pain: 4.3 ± 0.6; Image: 4.2 ± 0.6; Mental: 3.8 ± 0.8, Mean: 4.1 ± 0.5). Whites scored higher in the activity domain than Hispanic and other ethnicities, while African Americans scored higher in the pain domain than Hispanics (P < 0.05 for both). From the lowest income range to 125,000 dollars/yr, household income had a positive effect on the activity, image and mean SRS-22 score (P < 0.05 for all). Males scored higher than females in the mental health domain and mean SRS-22 (P < 0.0001). Dual parent versus single parent households had higher activity and mean SRS-22 scores (P < 0.005). We report that male gender, dual parent household, white race and increased household income were predictive of higher SRS-22 scores in healthy adolescents without scoliosis. The impact of these factors represents a meaningful clinical difference in SRS-22 performance.