Validity and reproducibility of the start back tool (Dutch version) in patients with low back pain in primary care settings
Jasper D. Bier,Raymond W. J. G. Ostelo,Miranda L. van Hooff,Bart W. Koes,Arianne P. Verhagen +4 more
TLDR
The SBT has been successfully translated into Dutch and the psychometric analysis showed acceptable results and, therefore, the SBT is a valid screening tool for patients with LBP in Dutch primary care.Abstract:
Objective. The purpose of this study was to translate and to investigate the reliability and validity of the STarT Back screening tool (SBT) in the primary care setting among patients with nonspecific low back pain (LBP). Design. The SBT was formally translated into Dutch following a multistep approach for forward and backward translation. General practitioners and physical therapists included patients with LBP. Methods. Patients completed a baseline questionnaire and a follow-up at 3 days and 3 months. The construct validity was calculated with Pearson’s correlation coefficient. The reproducibility was assessed using the quadratic weighted kappa and the specific agreement. Predictive validity was assessed using relative risk ratios for persisting disability at 3 months. Content validity was analyzed using floor and ceiling effects. Results. In total, 184 patients were included; 52.2% were categorized in the “low-risk” subgroup, 38.0% “medium-risk,” and 9.8% “high-risk.” For the construct validity we found, as expected, a moderate to high Pearson’s correlation for questions 3 to 9 and a low correlation for questions 1 and 2 with their respective reference questionnaires. The reproducibility had a quadratic weighted kappa of 0.65 and the specific agreement of 82.4% for “low-risk,” 53.3% for “medium-risk,” and 33.3% for “high-risk.” For the predictive validity for persisting disability we found a relative risk ratio for “medium-risk” of 1.8 (95% confidence interval [CI]: 1.0–3.1) and 2.7 (95% CI: 1.4–4.9) for “high-risk” compared with “low-risk.” For the content validity, we found that no floor and ceiling effects were present. Limitations. There was a relatively small sample size for the retest reliability study. Patients were not compared between physical therapist and GP, as there were not enough patients in both groups. For practical reasons, the patients filled out the baseline questionnaire after receiving the first treatment/consultation; however, the questionnaire is intended to be filled in before the first consultation/treatment. Conclusion. The SBT has been successfully translated into Dutch. The psychometric analysis showed acceptable results and, therefore, the SBT is a valid screening tool for patients with LBP in Dutch primary care.read more
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Artificial intelligence to improve back pain outcomes and lessons learnt from clinical classification approaches: three systematic reviews
Scott D Tagliaferri,Maia Angelova,Xiaohui Zhao,Patrick J. Owen,Clint T. Miller,Tim Wilkin,Daniel L. Belavy +6 more
TL;DR: There is a need to establish reliability, validity, and prognostic capacity of AI/ML techniques in LBP as well as its ability to inform treatment allocation for improved patient outcomes and/or reduced healthcare costs.
Journal ArticleDOI
Can Primary Care for Back and/or Neck Pain in the Netherlands Benefit From Stratification for Risk Groups According to the STarT Back Tool Classification?
Jasper D. Bier,Janneke J.W. Sandee-Geurts,Raymond W. J. G. Ostelo,Bart W. Koes,Arianne P. Verhagen +4 more
TL;DR: Current Dutch primary care for patients with nonspecific LBP, NP, or both does not correspond to the recommended stratified-care approach based on the SBT, as most patients receive medium-risk treatment.
Journal ArticleDOI
Predictive Validity of the STarT Back Tool for Risk of Persistent Disabling Back Pain in a U.S. Primary Care Setting
TL;DR: The STarT Back risk groups successfully separated people with back pain into distinct categories of risk for persistent disabling back pain at 6-month follow-up in U.S. primary care.
Journal ArticleDOI
Prognostic factors for persistent pain after a first episode of nonspecific idiopathic, non-traumatic neck pain: A systematic review.
TL;DR: This review identifies prognostic factors for neck pain, of which only a few are modifiable, and moderate evidence for 'age> 40 years' and 'concomitant back pain' to be prognostic for 'pain intensity'.
Journal ArticleDOI
Can the STarT Back Tool predict health-related quality of life and work ability after an acute/subacute episode with back or neck pain? A psychometric validation study in primary care
Malin Forsbrand,Birgitta Grahn,Jonathan C. Hill,Ingemar F Petersson,Charlotte Post Sennehed,Kjerstin Stigmar +5 more
TL;DR: The SBT is an appropriate tool for identifying patients with a poor long-term HRQoL and/ or work ability outcome in a population with acute/subacute back and/or neck pain, and maybe a useful adjunct to primary care physiotherapy assessment and practice.
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