The use of the start back screening tool for predicting clinical outcomes of patients with nonspecific low back pain when administered at multiple time points

Abstract

Background: Low back pain is an important public health problem and highly prevalent worldwide. The prognosis of low back pain is related to the time duration of the symptoms, but also may be influenced by other intrinsic or extrinsic characteristics of the patients. The instrument STarT (Subgroups Target Treatment) Back Screening Tool (SBST) was developed to screen and stratify patients with low back pain into three subgroups, low, medium or high risk of having a poor prognosis. However, this classification at baseline does not take into account variables that can influence the prognosis during treatment or over time. Objective: To investigate the changes in the risk subgroup measured by the SBST over a period of 6 months and to assess the long-term predictive ability of the SBST when applied at different time points in patients with acute low back pain in patients who seek emergency treatment. Design: Two hundred patients with acute low back pain will be included in this study. Clinical outcomes of pain intensity and disability as well as SBST will be collected at baseline, 6 weeks, 3 and 6 months. Descriptive analyzes will be performed to describe the changes in the subgroups of SBST. Hierarchical linear regression models will be built to analyze the predictive ability of SBST when applied to different assessments. These models will be adjusted for potential confounders (age, gender and the outcome in the initial assessment). Expected results: This study expected to identify whether the changes that occur in SBST subgroups influence the predictive ability of the instrument, as well to identify what would be the best time for applying of SBST to predict pain intensity and disability at long-term. These results may provide new and important information, since the predictive ability of SBST has never been investigated in patients with acute low back pain who seek for emergency care. (AU)