Scoliosis Research Society Score (SRS 22r)

Evaluating patient's condition in idiopathic scoliosis – developed by the world's largest scoliosis association

The SRS-22r is a validated questionnaire intended to assess outcomes in patients with idiopathic scoliosis after spinal surgery. The first version, developed by the Scoliosis Research Society in 1999, had 24 items, and this was reduced to 22 items (accompanied by a name change) in the course of 3 major updates.

The measure covers 5 dimensions: pain, function, mental health, self-image and satisfaction with treatment. The SRS-22r is a valid tool for assessing patient-centered outcomes after scoliosis surgery, but has not been validated and is not intended for use for other patient populations.

Indication

The score was developed for the evaluation of patient outcomes after surgery for idiopathic scoliosis. 1 2 3

Items - Dimensions - Completion time

In the first version of the score the number of questions has been 24. That has been modified to a 23- and later a 22-item version. The most actual edition of the tool – the SRS 22r – consists of 22 items with 5 options to answer each question. Only one answer can be chosen. 4 5 domains are included in the questionnaire: pain (5 items), function (5 items), mental health (5 items), self image (5 items) and satisfaction with treatment (2 items). There is no information in literature yet. A completion time of 10 minutes can be assumed.

Scoring method of the scoliosis research society score

The response to each item is associated with a point score from 1 to 5. For each of the 5 dimensions, a dimension score is calculated as the mean of the item points scored on that dimension. A total score is generated by averaging all the item points.

If there are unanswered items, the “questions answered” denominator is reduced by the appropriate number. Items with more than 1 answer are removed from the calculation. Except for the satisfaction with treatment dimension, the dimensions cannot be scored if fewer than 3 items are answered.

Interpretation of the scoliosis research society score

For the dimension and total scores, the best possible score (associated with the best health status) is 5 and the worst possible score (associated with the worst imaginable health status) is 1.

Scoring example

Source: www.srs.org

The SRS-22r has been validated in several languages 5 6 7 8. An official English source document is available on the society’s homepage 9.
Scoliosis Research Society (Milwaukee, Wis., U.S.) 10
The score is available free of charge without a license.
The SRS-22r is a very specific tool for patients with idiopathic scoliosis. Moreover, the minimal important changes for the dimension and total scores are available, as well as normative data for the general population. 11 12
The questionnaire can only be used for patients with idiopathic scoliosis. The high number of questions might take older patients especially a long time to complete.
Not listed.

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References

  1. Haher, Thomas R., et al. “Results of the Scoliosis Research Society instrument for evaluation of surgical outcome in adolescent idiopathic scoliosis: a multicenter study of 244 patients.” Spine 24.14 (1999): 1435.
  2. Smith, Justin S., et al. “Risk-benefit assessment of surgery for adult scoliosis: an analysis based on patient age.” Spine 36.10 (2011): 817-824.
  3. Improvement of back pain with operative and nonoperative treatment in adults with scoliosis. Neurosurgery, 2009, 65. Jg., Nr. 1, S. 86-94.
  4. Asher, Marc A., Sue Min Lai, and Douglas C. Burton. “Further development and validation of the Scoliosis Research Society (SRS) outcomes instrument.” Spine 25.18 (2000): 2381-2386.
  5. Niemeyer, Thomas, et al. “Validity and reliability of an adapted german version of scoliosis research society-22 questionnaire.” Spine 34.8 (2009): 818-821.
  6. Asher, Marc, et al. “The reliability and concurrent validity of the scoliosis research society-22 patient questionnaire for idiopathic scoliosis.” Spine 28.1 (2003): 63-69.
  7. Climent, Jose M., et al. “Validity of the Spanish version of the Scoliosis Research Society-22 (SRS-22) patient questionnaire.” Spine 30.6 (2005): 705-709.
  8. Alanay, Ahmet, et al. “Reliability and validity of adapted Turkish Version of Scoliosis Research Society-22 (SRS-22) questionnaire.” Spine 30.21 (2005): 2464-2468.
  9. https://www.srs.org/UserFiles/file/outcomes/srs-22.pdf
  10. https://www.srs.org/professionals/online-education-and-resources/patient-outcome-questionnaires
  11. Diarbakerli, Elias, Anna Grauers, and Paul Gerdhem. “Population-based normative data for the Scoliosis Research Society 22r questionnaire in adolescents and adults, including a comparison with EQ-5D.” European Spine Journal 26.6 (2017): 1631-1637.
  12. Bagó, Juan, et al. “Minimal important differences of the SRS-22 Patient Questionnaire following surgical treatment of idiopathic scoliosis.” European Spine Journal 18.12 (2009): 1898-1904.

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