Use of Psychometric Measures and Nonorganic Signs Testing in Detecting Nomogenic Disorders in Low Back Pain Patients

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Abstract
The effect of financial compensation on responses to psychometric testing was studied in 231 chronic back pain patients. Item by item comparison of responses to two tests, readministered within 4 hours, yielded inconsistency scores. These inconsistency scores, along with scores on other psychometric measures and on Waddell's nonorganic signs test, of a group of 97 patients anticipating or receiving financial compensation (AFC), and a group of 134 patients not receiving or anticipating financial compensation (non-AFC) were compared. The AFC group had significantly higher mean scores than did the non-AFC group on the inconsistency measures, on almost all psychometric tests and on nonorganic signs. Almost all non-AFC subjects scored "0" on nonorganics, whereas 83% of AFC subjects scored "2" or higher. Prediction analysis revealed that the nonorganics score alone can predict AFC/non-AFC status; 90% of subjects were correctly classified. The inconsistency scores correctly classified 78%. Together, they correctly classified 93%. It was concluded that nonorganic scores and inconsistency scores (as defined by the investigators) distinguish between, and can predict membership in AFC and non-AFC groups. The significantly higher inconsistency scores obtained by the AFC group suggest that these psychometric test results are unreliable and hence invalid for this group.

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