Factor analysis of the North American Spine Society outcome assessment instrument: a study based on a spine registry of patients treated with lumbar and cervical disc arthroplasty.

Background context Studies involving factor analysis (FA) of the items in the North American Spine Society (NASS) outcome assessment instrument have revealed inconsistent factor structures for the individual items. Purpose This study examined whether the factor structure of the NASS varied in relation to the severity of the back/neck problem and differed from that originally recommended by the developers of the questionnaire, by analyzing data before and after surgery in a large series of patients undergoing lumbar or cervical disc arthroplasty. Study design/setting Prospective multicenter observational case series. Patient sample Three hundred ninety-one patients with low back pain and 553 patients with neck pain completed questionnaires preoperatively and again at 3 to 6 and 12 months follow-ups (FUs), in connection with the SWISSspine disc arthroplasty registry. Outcome measures North American Spine Society outcome assessment instrument. Methods First, an exploratory FA without a priori assumptions and subsequently a confirmatory FA were performed on the 17 items of the NASS-lumbar and 19 items of the NASS-cervical collected at each assessment time point. The item-loading invariance was tested in the German version of the questionnaire for baseline and FU. Results Both NASS-lumbar and NASS-cervical factor structures differed between baseline and postoperative data sets. The confirmatory analysis and item-loading invariance showed better fit for a three-factor (3F) structure for NASS-lumbar, containing items on “disability,” “back pain,” and “radiating pain, numbness, and weakness (leg/foot)” and for a 5F structure for NASS-cervical including disability, “neck pain,” “radiating pain and numbness (arm/hand),” “weakness (arm/hand),” and “motor deficit (legs).” Conclusions The best-fitting factor structure at both baseline and FU was selected for both the lumbar- and cervical-NASS questionnaires. It differed from that proposed by the originators of the NASS instruments. Although the NASS questionnaire represents a valid outcome measure for degenerative spine diseases, it is able to distinguish among all major symptom domains (factors) in patients undergoing lumbar and cervical disc arthroplasty; overall, the item structure could be improved. Any potential revision of the NASS should consider its factorial structure; factorial invariance over time should be aimed for, to allow for more precise interpretations of treatment success.

Digitization for Preservation and Access: Restoring the Usefulness of the Nitrate Negative Collections at the American Geographical Society Library

Film-based photographic collections of nitrate negatives pose major challenges to preservation and access because of unstable media and the lack of item-level indexing. Digitization offers an opportunity to capture the content of deteriorating negatives, to extend access to them, and to restore their usefulness as information resources. Digitization as a preservation strategy has been the subject of ongoing debate. This article contributes to the discussion by exploring access to and the preservation of film-based photographic collections and by presenting the digiti- zation project at the American Geographical Society Library as a case study. The project, Saving and Sharing the AGS Library’s Historic Nitrate Negative Images, was undertaken from 2010 to 2012 to preserve and provide access to over 69,000 nitrate negatives from its historic collections.

Transactions of the American Philosophical Society.

new ser.:v.2 (1825)

Transactions of the American Horticultural Society.

5

Transactions of the American Philosophical Society.

new ser.:v.16 (1890)

Transactions of the American Philosophical Society.

new ser.:v.3 (1830)

Transactions of the American Philosophical Society.

new ser.:v.10 (1853)

Transactions of the American Entomological Society

v. 47 1921

Transactions of the American Entomological Society

v. 46 1920

Reactor safety conference, jointly sponsored by American Nuclear Society, Atomic Industrial Forum [and] United States Atomic Energy Commission, New York City, October 31, 1957.

Cover title.