What is the NOOS?


The Neck OutcOme Score (NOOS) is developed as an instrument to assess the patients’ perception of their neck-related problems. It is a quantified measure of the patient’s neck disability according to WHO’s different levels of the international Classification of Functioning (ICF).

NOOS is intended for patients with neck-related problems.

NOOS is validated in a LK 1.0 version.

NOOS can be used over both short and long time intervals: to assess changes from week to week induced by treatment (medication, operation, physical therapy) or over years due to primary or post traumatic injuries.

NOOS can be used to assess groups and to monitor individuals.

NOOS content validity was ensured through focus groups interviews with 24 patients with neck pain, and 12 health care professionals [1].

The psychometric properties (reliability, validity, interpretability and responsiveness) have been evaluated in 196 patients with neck pain [2]. When the submitted report is publically available, this information will be updated with key findings.

NOOS includes 34 items divided into 5 subscales: ‘Mobility’ (7 items), ‘Symptoms’ (5 items), ‘Sleep disturbance’ (4 items), ‘Every day activity and pain’ (8 items) and ‘Participation in everyday life’ (10 items). The last week is taken into consideration when answering the questions. Standardized answer options are given (5 Likert boxes) and each question gets a score from 0 to 4. A normalized score (100 indicating no symptoms and 0 indicating extreme symptoms) is calculated for each subscale. The result can be plotted as an outcome profile.

NOOS is patient-administered. The format is user friendly, and it takes about 10-15 minutes to fill out.

NOOS is self-explanatory and was developed in an electronic version. It can be administered on any electronic device (computer, smartphone or tablet) in the waiting room or used as an emailed survey.

NOOS has been used in patients 18-89 years old.

NOOS validation work is ongoing and is currently available in two language versions, a Danish version and an English version.


1. Juul T, Søgaard K, Roos M. E, Davis AM. Development of a patient-reported outcome: the Neck OutcOme Score (NOOS) – content and construct validity. J Rehabil Med 2015; 47: 844-853.
2. Juul, T, Søgaard K, Davis AM, Roos M. E. Psychometric properties of the Neck OutcOme Score (NOOS), Neck Disability Index (NDI) and Short form-36 (SF-36) were evaluated in patients with neck pain. J Clin Epidemiol. 2016 Mar 30. pii: S0895-4356(16)30027-0. doi: 10.1016/j.jclinepi.2016.03.015. [Epub ahead of print]