A COMPARISON OF TWO PRIMARY CARE BACK PAIN SCREENING TOOLS

Abstract

Introduction: Detecting relevant clinical subgroups of patients with non-specific LBP is a priority for research as it has potential for improving treatment effectiveness. The STarT Back Tool (SBT) was recently developed and validated to subgroup LBP patients into targeted treatment pathways in primary care. This study tested the SBT’s criterion validity against a popular existing LBP subgrouping tool – the Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ).

Methods: 244 consecutive ‘non-specific’ LBP consulters at 8 GP practices aged 18–59 years were invited to complete a questionnaire. Measures included the OMPSQ & SBT; disability (RMDQ); pain intensity (11-item NRS); duration of symptoms; and demographics. Instruments were compared using Spearman’s rank correlation, discriminant analysis of subgroups, tests for allocation agreement and predictive validity using published data.

Results: Completed SBT (9-items) and OMPSQ (24-items) data was available for 130/244 patients (53%). The correlation of SBT and OMPSQ scores was ‘excellent (rs = 0.80, p=< 0.001). Subgroup characteristics from both tools were similar particularly among the ‘low’ risk groups, however, the proportion of patients allocated to ‘low’, ‘medium’ and ‘high’ risk groups were different, with more distressed patients in the SBT’s high risk group. The SBT better predicted pain and disability at 6 months and both equally predicted time off work.

Conclusion: The SBT psychometric properties perform as well or better than the OMPSQ, but the SBT is shorter and easier to score. It is therefore an appropriate alternative for screening LBP patients in primary care.