Comparison of the Swedish STarT Back Screening Tool and the Short Form of the Örebro Musculoskeletal Pain Screening Questionnaire in patients with acute or subacute back and neck pain

Abstract

BackgroundPatients with back and neck pain are often seen in primary care and it is important to provide them with tailored interventions based on risk stratification/triage. The STarT Back Screening Tool (SBT) is a widely used screening questionnaire which has not yet been validated for a population with back and/or neck pain with short duration. Our aim was to compare the concurrent validity of the SBT and the short form of the ÖMPSQ including psychometric properties and clinical utility in a primary care setting.MethodsPatients who applied for physiotherapy by direct access (January 2013 to January 2014) at 35 primary care centers in south Sweden, with acute or subacute back and/or neck pain, aged 18–67 years, who were not currently on sick leave or had been on sick leave less than 60 days were asked to complete the SBT and ÖMPSQ-short questionnaire (n = 329). We used the Spearman’s rank correlations to study correlations, cross tabulation and Cohen’s kappa to analyze agreement of patient classification. Clinical utility was described as clinician scoring miscalculations and misclassifications of total and/or subscale scores.ResultsCompleted SBT (9-items) and ÖMPSQ-short (10-items) data were available for 315/329 patients respectively. The statistical correlation for SBT and ÖMPSQ-short total scores was moderately strong (0.62, p < 0.01). In subgroup analyses, the correlations were 0.69 (p < 0.01) for males and 0.57 (p < 0.01) for females. The correlations were lower among older age groups, especially females over 50 years (0.21, p = 0.11). Classification to high or low risk for long-term pain and disability had moderate agreement (κ = 0.42). Observed classification agreement was 70.2%. The SBT had fewer miscalculations (13/315) than the ÖMPSQ-short (54/315).ConclusionsThe correlation between the SBT and the ÖMPSQ-short scores were moderately strong for individuals with acute or subacute back and/or neck pain. SBT seemed to be clinically feasible to use in clinical practice. We therefore suggest that SBT can be used for individuals with both BP and/or NP in primary care settings but it is important to be aware of that SBT’s agreement with the ÖMPSQ-short was poor among females aged over 50 years.Trial registrationClinicalTrials.gov ID: NCT02609750 Registered: November 18, 2015.

Association of STarT Back Tool and the short form of the Örebro Musculoskeletal Pain Screening Questionnaire with multidimensional risk factors

“…A cross-sectional study of non-specific LBP patients visiting a GP practice, using the Tampa Scale of Kinesiophobia questionnaire 10 has also shown a correlation between fear of movement and SBT or ÖMPSQ. Similar results with respect to fear of movement have been observed in later cross-cultural validation studies of SBT [29][30][31][32] . SBT total and/or psychosocial subscale scores have shown to be associated with LBP-related disability, bothersomeness, catastrophizing, and depression/ depressive symptoms 5,13,[29][30][31][32][33][34][35] .…”

Clinical assessment and patient-reported outcome measures in low-back pain – a survey among primary health care physiotherapists

“…The survey comprised four multiple choice questions on clinical tests: common clinical tests such as observation of posture; range of motion; neurological tests; muscle strength; muscle length; segmental movement of spinal segments; repeated movements according to Mechanical Diagnostics and Therapy (MDT) [30]; palpation for pain; examination of range of motion in nearby joints and the abdominal draw in maneuver while palpating for activity in the deep abdominals [31], as well as various tests used for observing movement control impairment [9,32]. Risk of chronicity € Orebro Musculoskeletal Pain Screening [45] or Start Back Screening Tool (STaRT) [46]; Self-efficacy (self-efficacy scale) [47]; Anxiety/depression [Hospital Anxiety and Depression Scale (HADS) [48], Montgomery Åsberg Depression Rating Scale (MADRS) [49], Hamilton Anxiety Rating Scale (HAM-A) [50], Beck's Depression Inventory (BDI) [51].…”

Risk classification of patients referred to secondary care for low back pain

“…One may ask whether these discrepancies were related to the fact that ÖMPSQ has five work-related questions and have been suggested to be a good predictor of future absenteeism [ 18 ], while Start Back does not include any work questions. Studies assessing the validity of the short-form ÖMPSQ that includes ten items, of which two covers work that is optional connected to the home or to paid work may support this hypothesis as it showed less discrepancies in classification when compared to STarT Back [ 17 , 26 ]. Because STarT Back does not cover work, we hypothesized that STarT Back could underestimate risk for participants with work-related obstacles for recovery.…”

“…It contains nine items covering eight domains, which were selected based on established prognostic factors suggested to affect probability of recovery. STarT Back was originally validated in England [ 9 ], and has been tested and adapted in a range of countries including Belgium [ 10 ], Denmark [ 11 , 12 ], Finland [ 13 ], China [ 14 ], Germany [ 15 ], Norway [ 16 ] and Sweden [ 17 ]. Most of these studies have been performed in primary care.…”