Featured 20 Years of COMI: Because treatment success is more than just an X-ray
How can we determine whether spinal surgery has truly been successful? Not just from the perspective of the treatment team, but from the patients’ perspective? A patient questionnaire was developed at the Schulthess Klinik precisely for this purpose. For two decades, the so-called COMI-back has been helping to reveal how patients are really faring after surgery on the lumbar spine.
COMI stands for Core Outcome Measures Index. The patient questionnaire helps to assess the impact of back pain and its treatment from the patients’ perspective. Today, it is one of the established tools in spinal research worldwide and is used in numerous countries and studies.
What matters is everyday life
Following spinal treatment, it is not just what can be seen on an X-ray or MRI that matters. Above all, what is crucial is how those affected cope in their everyday lives. Has the pain subsided? Can they sit, walk or work for longer periods again? Has their quality of life improved? The COMI asks precisely these questions and assesses the extent to which back pain affects everyday life and whether treatment has actually brought about a noticeable improvement.
The questionnaire has been deliberately kept short. This makes it easier to complete whilst ensuring meaningful results. In this way, feedback from many patients can be systematically recorded and analysed.
From Zurich to international research
What was developed 20 years ago as a tool for assessing back pain has long since established itself internationally. Today, the COMI is available in more than 20 languages and is used worldwide in research projects as well as in national and international databases. Adapted versions now also exist for the cervical spine, the hip and the knee. In this way, the COMI achieves something that is particularly valuable for research: it makes treatment outcomes comparable – over the years, across clinical settings and even across national borders.
Future patients will also benefit from this
Every question answered helps to improve our understanding of the treatment of spinal conditions. Feedback from thousands of patients helps to identify which treatments are particularly effective for which symptoms. This generates knowledge that feeds directly into the care of future patients.
Another step forward: COMI results can now also be compared with other internationally used questionnaires. This allows data from different clinics and studies to be analysed together. This strengthens international collaboration and creates an even broader knowledge base for the treatment of spinal conditions.
Two publications take stock
To mark the COMI’s 18th anniversary – effectively its coming of age – a team of researchers from the Schulthess Klinik took stock in two comprehensive review articles. The first publication examines the origins and further development of the COMI, as well as its significance for research. The second outlines how the questionnaire is structured, how the results are interpreted, and the areas in which it is currently used worldwide.
Both publications make it clear that, over the past two decades, the COMI has developed into a key tool for patient-centred spinal research. To this day, it helps to assess and improve treatments from the perspective of those affected.
