Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden.
Blekinge Centre of Competence, Landstinget Blekinge, Karlskrona, Sweden.
BMJ Open. 2018 Dec 22;8(12):e021748. doi: 10.1136/bmjopen-2018-021748.
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.
Prospective data from 35 primary care centres in south Sweden during 2013.
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%).
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).
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.
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.
NCT02609750; Results.
STarT 后背工具（SBT）在初级保健环境中对急性/亚急性背痛和/或颈痛的预测能力尚未针对健康相关生活质量（HRQoL）和工作能力结果进行评估。本研究的目的是评估 SBT 在具有急性/亚急性背痛和/或颈痛的人群中的长期随访中对 HRQoL 和工作能力结果的预测有效性。
2013 年，瑞典南部 35 个初级保健中心的前瞻性数据。
患有急性/亚急性背痛和/或颈痛的患者（n=329），年龄 18-67 岁，申请物理治疗时未休病假或病假不足 60 天，填写 SBT。238 名患者（72%）完成了长期随访（中位随访时间为 13 个月，范围为 11-27 个月），测量 HRQoL（EQ-5D）和工作能力（工作能力评分）。
根据 SBT 风险组分层，103（43%）、107（45%）和 28（12%）名患者分别被认为低、中、高风险。在所有三个 SBT 风险组中，HRQoL（p<0.001）和工作能力（p<0.001）在随访中均存在统计学显著差异。高风险组患者的 HRQoL（OR 6.16，95%CI 1.50 至 25.26）和工作能力（OR 5.08，95%CI 1.75 至 14.71）不良的风险显著增加。HRQoL 的 AUC 为 0.73（95%CI 0.61 至 0.84），工作能力的 AUC 为 0.68（95%CI 0.61 至 0.76）。
SBT 是一种用于识别急性/亚急性背痛和/或颈痛人群中 HRQoL 和/或工作能力预后不良的患者的合适工具，可能是初级保健物理治疗评估和实践的有用辅助工具。
NCT02609750；结果。
