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Can the STarT Back Tool predict health-related quality of life and work ability after an acute/subacute episode with back or neck pain? A psychometric validation study in primary care

Forsbrand, Malin H. LU ; Grahn, Birgitta LU ; Hill, Jonathan C. ; Petersson, Ingemar F. LU ; Post Sennehed, Charlotte LU and Stigmar, Kjerstin LU (2018) In BMJ Open 8(12). p.021748-021748
Abstract

OBJECTIVES: The predictive ability of the STarT Back Tool (SBT) has not yet been examined among acute/subacute back and/or neck pain in a primary care setting in respect to health-related quality of life (HRQoL) and work ability outcomes. The aim of this study was to evaluate the SBT's predictive validity for HRQoL and work ability outcomes at long-term follow-up in a population with acute/subacute back and/or neck pain. SETTING: Prospective data from 35 primary care centres in south Sweden during 2013. PARTICIPANTS: Patients (n=329) with acute/subacute back and/or neck pain, aged 18-67 years, not on sick leave or <60 days of sick leave completed the SBT when applying for physiotherapy treatment. Long-term follow-up measures (median... (More)

OBJECTIVES: The predictive ability of the STarT Back Tool (SBT) has not yet been examined among acute/subacute back and/or neck pain in a primary care setting in respect to health-related quality of life (HRQoL) and work ability outcomes. The aim of this study was to evaluate the SBT's predictive validity for HRQoL and work ability outcomes at long-term follow-up in a population with acute/subacute back and/or neck pain. SETTING: Prospective data from 35 primary care centres in south Sweden during 2013. PARTICIPANTS: Patients (n=329) with acute/subacute back and/or neck pain, aged 18-67 years, not on sick leave or <60 days of sick leave completed the SBT when applying for physiotherapy treatment. Long-term follow-up measures (median 13 months, range 11-27 months) of HRQoL (EQ-5D) and work ability (Work Ability Score) was completed by 238 patients (72%). OUTCOMES: The predictive ability of the SBT for HRQoL and work ability outcomes was examined using Kruskal-Wallis test, logistic regression and area under the curve (AUC). RESULTS: Based on SBT risk group stratification, 103 (43%), 107 (45%) and 28 (12%) patients were considered as low, medium and at high risk, respectively. There were statistically significant differences in HRQoL (p<0.001) and work ability (p<0.001) at follow-up between all three SBT risk groups. Patients in the high risk group had a significantly increased risk of having poor HRQoL (OR 6.16, 95% CI 1.50 to 25.26) and poor work ability (OR 5.08, 95% CI 1.75 to 14.71) vs the low risk group at follow-up. The AUC was 0.73 (95% CI 0.61 to 0.84) for HRQoL and 0.68 (95% CI 0.61 to 0.76) for work ability. CONCLUSIONS: The SBT is an appropriate tool for identifying patients with a poor long-term HRQoL and/or work ability outcome in a population with acute/subacute back and/or neck pain, and maybe a useful adjunct to primary care physiotherapy assessment and practice. TRIAL REGISTRATION NUMBER: NCT02609750; Results.

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; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
back pain, health related quality of life, neck pain, primary care, STarT Back Tool, work ability
in
BMJ Open
volume
8
issue
12
pages
021748 - 021748
publisher
BMJ Publishing Group
external identifiers
  • scopus:85058907164
  • pmid:30580256
ISSN
2044-6055
DOI
10.1136/bmjopen-2018-021748
project
WorkUp
language
English
LU publication?
yes
id
d48470b3-cc2d-4ea0-a0d0-d8f08e9e969b
date added to LUP
2019-01-03 09:20:06
date last changed
2024-03-02 16:19:18
@article{d48470b3-cc2d-4ea0-a0d0-d8f08e9e969b,
  abstract     = {{<p>OBJECTIVES: The predictive ability of the STarT Back Tool (SBT) has not yet been examined among acute/subacute back and/or neck pain in a primary care setting in respect to health-related quality of life (HRQoL) and work ability outcomes. The aim of this study was to evaluate the SBT's predictive validity for HRQoL and work ability outcomes at long-term follow-up in a population with acute/subacute back and/or neck pain. SETTING: Prospective data from 35 primary care centres in south Sweden during 2013. PARTICIPANTS: Patients (n=329) with acute/subacute back and/or neck pain, aged 18-67 years, not on sick leave or &lt;60 days of sick leave completed the SBT when applying for physiotherapy treatment. Long-term follow-up measures (median 13 months, range 11-27 months) of HRQoL (EQ-5D) and work ability (Work Ability Score) was completed by 238 patients (72%). OUTCOMES: The predictive ability of the SBT for HRQoL and work ability outcomes was examined using Kruskal-Wallis test, logistic regression and area under the curve (AUC). RESULTS: Based on SBT risk group stratification, 103 (43%), 107 (45%) and 28 (12%) patients were considered as low, medium and at high risk, respectively. There were statistically significant differences in HRQoL (p&lt;0.001) and work ability (p&lt;0.001) at follow-up between all three SBT risk groups. Patients in the high risk group had a significantly increased risk of having poor HRQoL (OR 6.16, 95% CI 1.50 to 25.26) and poor work ability (OR 5.08, 95% CI 1.75 to 14.71) vs the low risk group at follow-up. The AUC was 0.73 (95% CI 0.61 to 0.84) for HRQoL and 0.68 (95% CI 0.61 to 0.76) for work ability. CONCLUSIONS: The SBT is an appropriate tool for identifying patients with a poor long-term HRQoL and/or work ability outcome in a population with acute/subacute back and/or neck pain, and maybe a useful adjunct to primary care physiotherapy assessment and practice. TRIAL REGISTRATION NUMBER: NCT02609750; Results.</p>}},
  author       = {{Forsbrand, Malin H. and Grahn, Birgitta and Hill, Jonathan C. and Petersson, Ingemar F. and Post Sennehed, Charlotte and Stigmar, Kjerstin}},
  issn         = {{2044-6055}},
  keywords     = {{back pain; health related quality of life; neck pain; primary care; STarT Back Tool; work ability}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{12}},
  pages        = {{021748--021748}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{Can the STarT Back Tool predict health-related quality of life and work ability after an acute/subacute episode with back or neck pain? A psychometric validation study in primary care}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2018-021748}},
  doi          = {{10.1136/bmjopen-2018-021748}},
  volume       = {{8}},
  year         = {{2018}},
}