Subgrouping low back pain: a comparison of the STarT Back Tool with the Orebro Musculoskeletal Pain Screening Questionnaire
Open accessAbstract
Introduction 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. Aim: To test the SBT's concurrent validity against an existing, popular LBP subgrouping tool, the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ), and to compare the clinical characteristics of subgroups identified by each tool. Methods: Two hundred and forty‐four consecutive ‘non‐specific’ LBP consulters at 8 UK GP practices aged 18–59 years were invited to complete a questionnaire. Measures included the ÖMPSQ 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. Results: Completed SBT (9‐items) and ÖMPSQ (24‐items) data was available for 130/244 patients (53%). The correlation of SBT and ÖMPSQ 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 ÖMPSQ was better at discriminating pain intensity, while the SBT was better for discriminating bothersomeness of back pain and referred leg pain. Conclusions: The SBT baseline psychometrics performed similarly to the ÖMPSQ, but the SBT is shorter and easier to score and is an appropriate alternative for identifying high risk LBP patients in primary care.
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Recent work, such as the STarT Back project, has made important advances in prognostic stratification of patients with chronic low back pain.
“Recent work such as the STarT Back project from the U.K. has made important advances in this regard,57–60”
From Report of the NIH Task Force on research standards for chronic low back pain. (2014) · cites this paper as [58]
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Örebro Musculoskeletal Pain Screening Questionnaire Short-Form and STarT Back Screening Tool
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- Authors
- Hill, J. C., Dunn, K. M., Main, C. J., & Hay, E. M.
- Affiliations
- Keele University (GB)
- Corresponding author
- Hill, Jonathan C.
- Venue
- European Journal of Pain
- Publisher
- Wiley
- Published
- 2010-01
- Volume
- 14
- Issue
- 1
- Pages
- 83-89
- ISSN
- 1090-3801 (ISSN-L)
- 1532-2149
- PMC
- PMC2809923
- OpenAlex
- W1978916560
- Cited by
- 207
- References
- 34
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 4 · 2023: 19 · 2022: 11 · 2021: 16 · 2020: 12 · 2019: 6 · 2018: 17 · 2017: 14 · 2016: 12 · 2015: 11 · 2014: 18 · 2013: 13 · 2012: 14
- FWCI
- 9.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- European Journal of Pain (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust (083572)
- National Institute for Health and Care Research (RP-PG-0707-10131)
- Keele University
- Versus Arthritis (13413)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- low back pain, STarT Back Tool, Örebro Musculoskeletal Pain Screening Questionnaire, subgrouping, non-specific low back pain, concurrent validity, psychometric properties, secondary prevention, primary care, pain catastrophizing, fear-avoidance beliefs
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Data Collection, Disability Evaluation, Fear, Female, Humans, Leg, Male, Middle Aged, Musculoskeletal Diseases, Pain Measurement, Surveys and Questionnaires, Reference Standards, ROC Curve, Socioeconomic Factors, Low Back Pain, Risk Assessment
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