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Unsgaard-Tøndel M1, Kregnes IG2, Nilsen TIL3, Marchand GH1, Askim T1
1Norwegian University of Science and Technology / St.Olavs Hospital, Neuromedicine and Movement Science, Trondheim, Norway, 2St. Olav’s Hospital, Department of Physical Medicine and Rehabilitation, Trondheim, Norway, 3Norwegian University of Science and Technology, Public Health and Nursing, Trondheim, Norway
Background: Nonspecific low back pain is characterized by a wide range of possible triggering and conserving factors, and initial screening needs to scope widely with multilevel addressment of possible factors contributing to the pain experience. Screening tools for classification of patients have been developed to support clinicians
Purpose: The primary aim of this study was to assess the criterion validity of STarT Back Screening Tool (STarT Back) against the more comprehensive Örebro Musculoskeletal Pain Questionnaire (ÖMPSQ), in a Norwegian sample of patients referred to secondary care for low back pain. Secondary aims were to assess risk classification of the patients, as indicated by both instruments, and to compare pain and work characteristics between patients in the different STarT Back risk categories.
Methods: An observational, cross-sectional survey among patients with low back pain referred to outpatient secondary care assessment at Trondheim University Hospital, Norway. Cohen's Kappa coefficient, Pearson's r and a Bland-Altman plot were used to assess criterion validity of STarT Back against ÖMPSQ. Furthermore, linear regression was used to estimate mean differences with 95% CI in pain and work related variables between the risk groups defined by the STarT Back tool.
Results: A total of 182 persons participated in the study. The Pearsons correlation coefficient for correspondence between scores on ÖMPSQ and STarT Back was 0.76. The Kappa value for classification agreement between the instruments was 0.35. Risk group classification according to STarT Back allocated 34.1 percent of the patients in the low risk group, 42.3 percent in the medium risk, and 23.6 percent in the high risk group. According to ÖMPSQ, 24.7 percent of the participants were allocated in the low risk group, 28.6 percent in the medium risk, and 46.7 percent in the high risk group. Patients classified with high risk according to Start Back showed a higher score on pain and work related characteristics as measured by ÖMPSQ.
Conclusion(s): The correlation between score on the screening tools was good, while the classification agreement between the screening instruments was low
Implications: Screening for work factors may be important in patients referred to multidisciplinary management in secondary care.
Keywords: Primary care, Multidisiplinary, Work
Funding acknowledgements: Not applicable.
Purpose: The primary aim of this study was to assess the criterion validity of STarT Back Screening Tool (STarT Back) against the more comprehensive Örebro Musculoskeletal Pain Questionnaire (ÖMPSQ), in a Norwegian sample of patients referred to secondary care for low back pain. Secondary aims were to assess risk classification of the patients, as indicated by both instruments, and to compare pain and work characteristics between patients in the different STarT Back risk categories.
Methods: An observational, cross-sectional survey among patients with low back pain referred to outpatient secondary care assessment at Trondheim University Hospital, Norway. Cohen's Kappa coefficient, Pearson's r and a Bland-Altman plot were used to assess criterion validity of STarT Back against ÖMPSQ. Furthermore, linear regression was used to estimate mean differences with 95% CI in pain and work related variables between the risk groups defined by the STarT Back tool.
Results: A total of 182 persons participated in the study. The Pearsons correlation coefficient for correspondence between scores on ÖMPSQ and STarT Back was 0.76. The Kappa value for classification agreement between the instruments was 0.35. Risk group classification according to STarT Back allocated 34.1 percent of the patients in the low risk group, 42.3 percent in the medium risk, and 23.6 percent in the high risk group. According to ÖMPSQ, 24.7 percent of the participants were allocated in the low risk group, 28.6 percent in the medium risk, and 46.7 percent in the high risk group. Patients classified with high risk according to Start Back showed a higher score on pain and work related characteristics as measured by ÖMPSQ.
Conclusion(s): The correlation between score on the screening tools was good, while the classification agreement between the screening instruments was low
Implications: Screening for work factors may be important in patients referred to multidisciplinary management in secondary care.
Keywords: Primary care, Multidisiplinary, Work
Funding acknowledgements: Not applicable.
Topic: Musculoskeletal: spine; Disability & rehabilitation; Musculoskeletal
Ethics approval required: No
Institution: Regional Committee Medical and Health Research Ethics in North Norway
Ethics committee: 2014/341/REC North.
Reason not required: The Regional Committee for Medical and Health Research Ethics in North Norway (REC North) defined the project as health service research. Such research is not regulated by the Norwegian legislation for health research (2014/341/REC North). Hence, the project was approved by the Norwegian Centre for Research Data (No 38883). Informed consent was signed by all participants.
All authors, affiliations and abstracts have been published as submitted.
