Research Department, Spine Centre of Southern Denmark, Hospital Lillebaelt, Institute of Regional Health Services Research, University of Southern Denmark, A Member of the Clinical Locomotion Network, Oestre Hougvej 55, Middelfart 5500, Denmark.
Eur Spine J. 2013 Aug;22(8):1859-67. doi: 10.1007/s00586-013-2690-z. Epub 2013 Feb 10.
The STarT Back Tool (SBT) was recently translated into Danish and its concurrent validity described. This study tested the predictive validity of the Danish SBT.
Danish primary care patients (n = 344) were compared to a UK cohort. SBT subgroup validity for predicting high activity limitation at 3 months' follow-up was assessed using descriptive proportions, relative risks, AUC and odds ratios.
The SBT had a statistically similar predictive ability in Danish primary care as in UK primary care. Unadjusted relative risks for poor clinical outcome on activity limitation in the Danish cohort were 2.4 (1.7-3.4) for the medium-risk subgroup and 2.8 (1.8-3.8) for the high-risk subgroup versus 3.1 (2.5-3.9) and 4.5 (3.6-5.6) for the UK cohort. Adjusting for confounders appeared to explain the lower predictive ability of the Danish high-risk group.
The Danish SBT distinguished between low- and medium-risk subgroups with a similar predictive ability of the UK SBT. That distinction is useful information for informing patients about their expected prognosis and may help guiding clinicians' choice of treatment. However, cross-cultural differences in the SBT psychosocial subscale may reduce the predictive ability of the high-risk subgroup in Danish primary care.
STarT Back 工具（SBT）最近被翻译成丹麦语，并描述了其同时效度。本研究测试了丹麦 SBT 的预测效度。
将丹麦初级保健患者（n=344）与英国队列进行比较。使用描述性比例、相对风险、AUC 和优势比评估 SBT 亚组对 3 个月随访时高活动受限的预测价值。
SBT 在丹麦初级保健中的预测能力与英国初级保健中的预测能力具有统计学上的相似性。未经调整的丹麦队列中活动受限不良临床结局的相对风险为中危亚组的 2.4（1.7-3.4）和高危亚组的 2.8（1.8-3.8），而英国队列的相对风险为 3.1（2.5-3.9）和 4.5（3.6-5.6）。调整混杂因素后，丹麦高危组的预测能力似乎有所下降。
丹麦 SBT 能够区分低危和中危亚组，与英国 SBT 的预测能力相似。这种区分对于告知患者预期预后非常有用，并可能有助于指导临床医生选择治疗方法。然而，SBT 社会心理分量表在跨文化方面的差异可能会降低丹麦初级保健中高危亚组的预测能力。
