These data provide both validation and st and ards for other users and indicate the power of the instrument for detecting change in sample population s. CONCLUSIONS The  ODI  remains a valid and vigorous measure and has been a worthwhile outcome measure .
The behavior of the instrument is incompletely understood , particularly in sensitivity to real change
STUDY DESIGN The Oswestry Disability Index ( ODI ) has become one of the principal condition-specific outcome measures used in the management of spinal disorders .
This review is based on publications using the ODI identified from the authors ' personal data bases , the Science Citation Index , and h and search es of Spine and current textbooks of spinal disorders .
OBJECTIVES To review the versions of this instrument , document methods by which it has been vali date d , collate data from scores found in normal and back pain population s , provide curves for power calculations in studies using the ODI , and maintain the ODI as a gold st and ard outcome measure .
SUMMARY OF BACKGROUND DATA It has now been 20 years since its original publication .
More than 200 citations exist in the Science Citation Index .
One‐Year Follow‐up Comparison of the Cost and Effectiveness of Chiropractic and Physiotherapy as Primary Management for Back Pain: Subgroup Analysis, Recurrence, and Additional Health Care Utilization
Study Design . A r and omized trial was conducted in which patients with back and neck pain , visiting a general practitioner , were allocated to chiropractic or physiotherapy . Objectives . To compare outcome and costs of chiropractic and physiotherapy as primary treatment for patients with back and neck pain , with special reference to subgroups , recurrence rate , and additional health care use at follow‐up evaluation 12 months after treatment . Summary of Background Data . Earlier studies on the effect of spinal manipulation have shown inconsistent results . Mostly they include only short‐term follow‐up periods , and few cost‐effectiveness analyses have been made . Methods . A group of 323 patients aged 18‐60 years who had no contraindications to manipulation and who had not been treated within the previous month were included . Outcome measures were changes in Oswestry scores , pain intensity , and general health ; recurrence rate ; and direct and indirect costs . Results . No differences were detected in health improvement , costs , or recurrence rate between the two groups . According to Oswestry score , chiropractic was more favorable for patients with a current pain episode of less than 1 week ( 5 % ) and physiotherapy for patients with a current pain episode of greater than 1 month ( 6.8 % ) . Nearly 60 % of the patients reported two or more recurrences . More patients in the chiropractic group ( 59 % ) than in the physiotherapy group ( 41 % ) sought additional health care . Costs varied considerably among individuals and subgroups ; the direct costs were lower for physiotherapy in a few subgroups . Conclusions . Effectiveness and costs of chiropractic or physiotherapy as primary treatment were similar for the total population , but some differences were seen according to subgroups . Back problems often recurred , and additional health care was common . Implication s of the result are that treatment policy and clinical decision models must consider subgroups and that the problem often is recurrent . Models must be implemented and tested
These data provide both validation and st and ards for other users and indicate the power of the instrument for detecting change in sample population s. CONCLUSIONS The  ODI  remains a valid and vigorous measure and has been a worthwhile outcome measure .
The behavior of the instrument is incompletely understood , particularly in sensitivity to real change
STUDY DESIGN The Oswestry Disability Index ( ODI ) has become one of the principal condition-specific outcome measures used in the management of spinal disorders .
This review is based on publications using the ODI identified from the authors ' personal data bases , the Science Citation Index , and h and search es of Spine and current textbooks of spinal disorders .
OBJECTIVES To review the versions of this instrument , document methods by which it has been vali date d , collate data from scores found in normal and back pain population s , provide curves for power calculations in studies using the ODI , and maintain the ODI as a gold st and ard outcome measure .
SUMMARY OF BACKGROUND DATA It has now been 20 years since its original publication .
More than 200 citations exist in the Science Citation Index .