Psychometric Measurement Properties and Clinical Utility of the Keele STarT Back Screening Tool in People With Low Back Pain

Abstract

Low back pain is commonly experienced by people throughout the world, with the 1-year global prevalence rate estimated at 38.1%, and the 1-year global incidence of people who experience a first-ever episode of low back pain ranging from 6.3% to 15.4%.1 Yet, the perceived burden of low back pain is often considered minimal, despite that low back pain has been associated with significant activity limitations, work interference, and financial burden worldwide.2 It is important for clinicians to screen for individuals with low back pain in order to identify and prioritize treatment. The Keele STarT Back Screening Tool (SBST)3., 4. is a brief 9-item instrument used to identify prognostic indicators important for clinicians to make treatment-planning decisions. The SBST assesses 8 unique domains and provides 2 scores for interpretation: (1) a total tool score, and (2) a psychosocial distress score. Clinically derived cut-off scores have been established using receiver operating characteristic analyses3., 4.; the SBST demonstrates adequate convergent and predictive validity with criterion-standard measures of disability and functioning.3 Adequate to poor ceiling and floor effects have been reported for the SBST.5 The SBST total score and psychosocial subscale demonstrate adequate test-retest reliability and adequate internal consistency.3 The SBST is free to use and can be administered in 5 to 10 minutes, making it a feasible screening tool for use in clinical practice.