Comparison of the Swedish STarT Back Screening Tool and the Short Form of the \xd6rebro Musculoskeletal Pain Screening Questionnaire in patients with acute or subacute back and neck pain

Kjerstin Stigmar,Birgitta Grahn,Jonathan C. Hill,Charlotte Post Sennehed,Ingemar F. Petersson,Malin Forsbrand

doi:10.1186/s12891-017-1449-9

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.

Highlights

Patients 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
Musculoskeletal disorders are very common in the general population worldwide [1,2,3] causing disability for the individual and high costs for the society [4,5,6] The Global Burden of Disease study reported in 2012 that low back pain and neck pain (NP) was one of five top ranked causes for years lived with disability [7] and in European countries, individuals with back and NP constitute a large proportion of health care seeking in primary care [8, 9]
There were 329 patients who consented to participate in the study and all patients completed the STarT Back Screening Tool (SBT) and the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ)-short questionnaires at the first physiotherapy session

Summary

Introduction

Patients 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. Musculoskeletal disorders are very common in the general population worldwide [1,2,3] causing disability for the individual and high costs for the society [4,5,6] The Global Burden of Disease study reported in 2012 that low back pain and neck pain (NP) was one of five top ranked causes for years lived with disability [7] and in European countries, individuals with back and NP constitute a large proportion of health care seeking in primary care [8, 9]. In a Swedish cohort of individuals seeking care for nonspecific low back pain or NP about half of the population reported pain and disability 5 years after onset [15]. A clinical and research priority is to, at an early stage, identify subgroups of patients with nonspecific BP and NP who are at risk of developing long-standing disability, in order to optimize treatment [17, 24]

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