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Feasibility of the STarT back screening tool in chiropractic clinics: a cross-sectional study of patients with low back pain.

Kongsted A, Johannesen E, Leboeuf-Yde C - Chiropr Man Therap (2011)

Bottom Line: The SBT risk groups were positively associated with all of the psychological questionnaires.The SBT high risk group had positive likelihood ratios for having a risk profile on the psychological scales ranging from 3.8 (95% CI 2.3 - 6.3) for the MDI to 7.6 (95% CI 4.9 - 11.7) for the FABQ.If the tool proves to predict prognosis in future studies, it would be a relevant alternative in clinical practice to other more comprehensive questionnaires.

View Article: PubMed Central - HTML - PubMed

Affiliation: Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Odense, Part of Clinical Locomotion Network, Denmark. a.kongsted@nikkb.dk.

ABSTRACT
The STarT back screening tool (SBT) allocates low back pain (LBP) patients into three risk groups and is intended to assist clinicians in their decisions about choice of treatment. The tool consists of domains from larger questionnaires that previously have been shown to be predictive of non-recovery from LBP. This study was performed to describe the distribution of depression, fear avoidance and catastrophising in relation to the SBT risk groups. A total of 475 primary care patients were included from 19 chiropractic clinics. They completed the SBT, the Major Depression Inventory (MDI), the Fear Avoidance Beliefs Questionnaire (FABQ), and the Coping Strategies Questionnaire. Associations between the continuous scores of the psychological questionnaires and the SBT were tested by means of linear regression, and the diagnostic performance of the SBT in relation to the other questionnaires was described in terms of sensitivity, specificity and likelihood ratios.In this cohort 59% were in the SBT low risk, 29% in the medium risk and 11% in high risk group. The SBT risk groups were positively associated with all of the psychological questionnaires. The SBT high risk group had positive likelihood ratios for having a risk profile on the psychological scales ranging from 3.8 (95% CI 2.3 - 6.3) for the MDI to 7.6 (95% CI 4.9 - 11.7) for the FABQ. The SBT questionnaire was feasible to use in chiropractic practice and risk groups were related to the presence of well-established psychological prognostic factors. If the tool proves to predict prognosis in future studies, it would be a relevant alternative in clinical practice to other more comprehensive questionnaires.

No MeSH data available.


Related in: MedlinePlus

Allocation of patients into risk groups according to their SBT-scores. The illustrating was adapted from http://www.keele.ac.uk/research/pchs/pcmrc/dissemination/tools/startback/.
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Figure 1: Allocation of patients into risk groups according to their SBT-scores. The illustrating was adapted from http://www.keele.ac.uk/research/pchs/pcmrc/dissemination/tools/startback/.

Mentions: The questionnaire package consisted of the STarT back screening tool (SBT)[6], the Major Depression Inventory (MDI) [8], the Fear Avoidance Beliefs Questionnaire (FABQ) [9], and the Coping Strategies Questionnaire (CSQ) [10]. The allocation of patients into the three SBT risk groups is described in Figure 1. The purpose and scoring of the questionnaires are summarized in Table 1. The dichotomizing of the MDI and the FABQ were based on previous recommendations [8,9]. The CSQ consists of six subscales, each identifying the use of one coping strategy. For the present study we used only the subscale related to catastrophising. There is no consensus about a cut-point on the catastrophising sub-scale of the CSQ, therefore, based on the distribution in our study, we decided to consider scores of 16 or more to indicate a high use of catastrophising strategies, as this was considered the point for the split between the majority of observations and the right hand tail of the estimates.


Feasibility of the STarT back screening tool in chiropractic clinics: a cross-sectional study of patients with low back pain.

Kongsted A, Johannesen E, Leboeuf-Yde C - Chiropr Man Therap (2011)

Allocation of patients into risk groups according to their SBT-scores. The illustrating was adapted from http://www.keele.ac.uk/research/pchs/pcmrc/dissemination/tools/startback/.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3105955&req=5

Figure 1: Allocation of patients into risk groups according to their SBT-scores. The illustrating was adapted from http://www.keele.ac.uk/research/pchs/pcmrc/dissemination/tools/startback/.
Mentions: The questionnaire package consisted of the STarT back screening tool (SBT)[6], the Major Depression Inventory (MDI) [8], the Fear Avoidance Beliefs Questionnaire (FABQ) [9], and the Coping Strategies Questionnaire (CSQ) [10]. The allocation of patients into the three SBT risk groups is described in Figure 1. The purpose and scoring of the questionnaires are summarized in Table 1. The dichotomizing of the MDI and the FABQ were based on previous recommendations [8,9]. The CSQ consists of six subscales, each identifying the use of one coping strategy. For the present study we used only the subscale related to catastrophising. There is no consensus about a cut-point on the catastrophising sub-scale of the CSQ, therefore, based on the distribution in our study, we decided to consider scores of 16 or more to indicate a high use of catastrophising strategies, as this was considered the point for the split between the majority of observations and the right hand tail of the estimates.

Bottom Line: The SBT risk groups were positively associated with all of the psychological questionnaires.The SBT high risk group had positive likelihood ratios for having a risk profile on the psychological scales ranging from 3.8 (95% CI 2.3 - 6.3) for the MDI to 7.6 (95% CI 4.9 - 11.7) for the FABQ.If the tool proves to predict prognosis in future studies, it would be a relevant alternative in clinical practice to other more comprehensive questionnaires.

View Article: PubMed Central - HTML - PubMed

Affiliation: Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Odense, Part of Clinical Locomotion Network, Denmark. a.kongsted@nikkb.dk.

ABSTRACT
The STarT back screening tool (SBT) allocates low back pain (LBP) patients into three risk groups and is intended to assist clinicians in their decisions about choice of treatment. The tool consists of domains from larger questionnaires that previously have been shown to be predictive of non-recovery from LBP. This study was performed to describe the distribution of depression, fear avoidance and catastrophising in relation to the SBT risk groups. A total of 475 primary care patients were included from 19 chiropractic clinics. They completed the SBT, the Major Depression Inventory (MDI), the Fear Avoidance Beliefs Questionnaire (FABQ), and the Coping Strategies Questionnaire. Associations between the continuous scores of the psychological questionnaires and the SBT were tested by means of linear regression, and the diagnostic performance of the SBT in relation to the other questionnaires was described in terms of sensitivity, specificity and likelihood ratios.In this cohort 59% were in the SBT low risk, 29% in the medium risk and 11% in high risk group. The SBT risk groups were positively associated with all of the psychological questionnaires. The SBT high risk group had positive likelihood ratios for having a risk profile on the psychological scales ranging from 3.8 (95% CI 2.3 - 6.3) for the MDI to 7.6 (95% CI 4.9 - 11.7) for the FABQ. The SBT questionnaire was feasible to use in chiropractic practice and risk groups were related to the presence of well-established psychological prognostic factors. If the tool proves to predict prognosis in future studies, it would be a relevant alternative in clinical practice to other more comprehensive questionnaires.

No MeSH data available.


Related in: MedlinePlus