Arthritis Research Campaign National Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, United Kingdom.
Eur J Pain. 2010 Jan;14(1):83-9. doi: 10.1016/j.ejpain.2009.01.003. Epub 2009 Feb 18.
Clinicians require brief, practical tools to help identify low back pain (LBP) subgroups requiring early, targeted secondary prevention. The STarT Back Tool (SBT) was recently validated to subgroup LBP patients into early treatment pathways.
To test the SBT's concurrent validity against an existing, popular LBP subgrouping tool, the Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ), and to compare the clinical characteristics of subgroups identified by each tool.
Two hundred and forty-four consecutive 'non-specific' LBP consulters at 8 UK GP practices aged 18-59years were invited to complete a questionnaire. Measures included the OMPSQ and SBT, disability, fear, catastrophising, pain intensity, episode duration and demographics. Instruments were compared using Spearman's correlations, tests for subgroup agreement and discriminant analysis of subgroup characteristics according to reference standards.
Completed SBT (9-items) and OMPSQ (24-items) data was available for 130/244 patients (53%). The correlation of SBT and OMPSQ scores was 'excellent (rs=0.80). Subgroup characteristics were similar across the low, medium and high subgroups, but, the proportions allocated to 'low', 'medium' and 'high' risk groups were different, with fewer patients in the SBT's high risk group. Both instruments similarly discriminated for reference standards such as disability, catastrophising, fear, comorbid pain and time off work. The OMPSQ was better at discriminating pain intensity, while the SBT was better for discriminating bothersomeness of back pain and referred leg pain.
The SBT baseline psychometrics performed similarly to the OMPSQ, but the SBT is shorter and easier to score and is an appropriate alternative for identifying high risk LBP patients in primary care.
临床医生需要简短实用的工具来帮助识别需要早期针对性二级预防的腰痛（LBP）亚组。STarT 背部工具（SBT）最近已被验证可将 LBP 患者分为早期治疗途径。
测试 SBT 与现有的流行的 LBP 分组工具（Orebro 肌肉骨骼疼痛筛查问卷（OMPSQ））的同时有效性，并比较每种工具确定的亚组的临床特征。
8 家英国 GP 诊所的 244 名连续“非特异性”LBP 咨询者年龄在 18-59 岁之间，被邀请填写一份问卷。测量包括 OMPSQ 和 SBT、残疾、恐惧、灾难化、疼痛强度、发作持续时间和人口统计学。使用 Spearman 相关系数、亚组协议测试和根据参考标准对亚组特征进行判别分析来比较仪器。
完成 SBT（9 项）和 OMPSQ（24 项）数据的患者为 130/244（53%）。SBT 和 OMPSQ 评分的相关性“极好（rs=0.80）。低、中、高亚组的亚组特征相似，但分配到“低”、“中”和“高”风险组的比例不同，SBT 的高风险组患者较少。两种仪器都能很好地区分残疾、灾难化、恐惧、合并疼痛和缺勤等参考标准。OMPSQ 更擅长区分疼痛强度，而 SBT 更擅长区分腰痛的困扰程度和放射腿痛。
SBT 的基线心理测量学表现与 OMPSQ 相似，但 SBT 更短、更容易评分，是在初级保健中识别高危 LBP 患者的合适替代方法。
