Abstract
Objective
The STarT Back Screening Tool (STarT) is a 9-item patient self-report questionnaire that classifies low back pain patients into low, medium or high risk of poor prognosis. When assessed by GPs, these subgroups can be used to triage patients into different evidence-based treatment pathways. The objective of this study was to translate the English version of STarT into Danish (STarT-dk) and test its discriminative validity.
Methods
Translation was performed using methods recommended by best practice translation guidelines. Psychometric validation of the discriminative ability was performed using the AUC statistic. The AUC was calculated for seven of the nine items where reference standards were available and compared with the original English version.
Results
The linguistic translation required minor semantic and layout alterations. The response options were changed from “agree/disagree” to “yes/no” for four items. No patients reported item ambiguity using the final version.
The AUC ranged from .735 to .855 (CI95% .678 to .897) in a Danish cohort (n=311) and .840 to .925 (CI95% .772 to .948) in the original English cohort (n=500). On four items, the AUC was statistically similar between the two cohorts but lower on three psychosocial sub-score items.
Conclusions
The translation was linguistically accurate and the discriminative validity broadly similar, with some differences probably due to differences in severity between the cohorts and the Danish reference standard questionnaires not having been validated. Despite those differences, we believe the results show that the STarT-dk has sufficient patient acceptability and discriminative validity to be used in Denmark.
Conflicts of interest
None
Sources of funding
This study was financed by a grant from the Region of Southern Denmark.
This has not been presented at a national meeting.
