Cited by 207Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyMedical Practices and Rehabilitation

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Subgrouping low back pain: a comparison of the STarT Back Tool with the Orebro Musculoskeletal Pain Screening Questionnaire

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Hill, Jonathan C., Dunn, Kate M., Main, Chris J., Hay, Elaine M.·2010·European Journal of Pain

DOI 10.1016/j.ejpain.2009.01.003PMC PMC2809923

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Abstract

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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Fig. 1 Box plot graph of the ÖMPSQ total scores against (a) the SBT total score and (b) the SBT psychosocial subscale.CC BY-NC-ND · PubMed Central

Fig. 2 Receiver operating characteristic (ROC) curves of ÖMPSQ and SBT scores against reference standards for (a) disability and pain, (b) catastrophising and fear, (c) referred leg pain and bothersomeness, and (d) time off work and episode duration.CC BY-NC-ND · PubMed Central

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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.
ORCID: Hill, Jonathan C.
Dunn, Kate M.
Main, Chris J.
Hay, Elaine M.
Venue: European Journal of Pain
Publisher: Wiley
Published: 2010-01
Volume: 14
Issue: 1
Pages: 83-89
ISSN: 1090-3801 (ISSN-L)
1532-2149
DOI: 10.1016/j.ejpain.2009.01.003
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: cc-by-nc-nd
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 742 d)
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 › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Orthopedics and Sports 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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Subgrouping low back pain: a comparison of the STarT Back Tool with the Orebro Musculoskeletal Pain Screening Questionnaire

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