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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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author
organization
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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
British Medical Journal Publishing Group
external identifiers
  • scopus:85058907164
ISSN
2044-6055
DOI
10.1136/bmjopen-2018-021748
language
English
LU publication?
yes
id
d48470b3-cc2d-4ea0-a0d0-d8f08e9e969b
date added to LUP
2019-01-03 09:20:06
date last changed
2019-02-20 11:41:21
@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},
  keyword      = {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    = {British Medical Journal 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},
  volume       = {8},
  year         = {2018},
}