Trial reportBMC musculoskeletal disorders2008
A randomised clinical trial of subgrouping and targeted treatment for low back pain compared with best current care. The STarT Back Trial Study Protocol.
Trial report in BMC musculoskeletal disorders, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Models of care for managing non-specific low back pain.The Cochrane database of systematic reviews · 2025Pooled it
- Do recommended interventions widen or narrow inequalities in musculoskeletal health? An equity-focussed systematic review of differential effectiveness.Journal of public health (Oxford, England) · 2022Pooled it
- Low back pain.The Journal of orthopaedic and sports physical therapy · 2012Guideline
- [Effectiveness of a risk-tailored short intervention to prevent chronic low back pain : A cluster-randomized study in general practice].Schmerz (Berlin, Germany) · 2019Trial
- Effect of Low Back Pain Risk-Stratification Strategy on Patient Outcomes and Care Processes: the MATCH Randomized Trial in Primary Care.Journal of general internal medicine · 2018Trial
- Effectiveness of three interventions for secondary prevention of low back pain in the occupational health setting - a randomised controlled trial with a natural course control.BMC public health · 2018Trial
- Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis.The journal of pain · 2017Trial
- Pragmatic Implementation of a Stratified Primary Care Model for Low Back Pain Management in Outpatient Physical Therapy Settings: Two-Phase, Sequential Preliminary Study.Physical therapy · 2015Trial
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2012Trial
- Exploring the cost-utility of stratified primary care management for low back pain compared with current best practice within risk-defined subgroups.Annals of the rheumatic diseases · 2012Trial
- Low back pain subgroups using fear-avoidance model measures: results of a cluster analysis.The Clinical journal of pain · 2012Trial
- Trial
- Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial.Lancet (London, England) · 2011Trial
- Specific treatment of problems of the spine (STOPS): design of a randomised controlled trial comparing specific physiotherapy versus advice for people with subacute low back disorders.BMC musculoskeletal disorders · 2011Trial
- IMPaCT Back study protocol. Implementation of subgrouping for targeted treatment systems for low back pain patients in primary care: a prospective population-based sequential comparison.BMC musculoskeletal disorders · 2010Trial
- Integrated disability evaluation in low back pain: feasibility and multidomain profiling from the EL DORADO cohort.Frontiers in rehabilitation sciences · 2026Article
- Optimizing osteoarthritis care through clinical and community partnership: Results of an exploratory trial.Osteoarthritis and cartilage open · 2025Article
- Efficacy of a Psychologically-Informed Physiotherapy Intervention in Patients with Chronic Low Back Pain at High Risk of Poor Prognosis: A Pilot and Feasibility Randomized Controlled Trial.Physiotherapy Canada. Physiotherapie Canada · 2024Article
- A clinical tool to identify older women with back pain at high risk of osteoporotic vertebral fractures (Vfrac): a population-based cohort study with exploratory economic evaluation.Age and ageing · 2022Article
- Validation of the German version of the STarT-MSK-Tool: A cohort study with patients from physiotherapy clinics.PloS one · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
backgroundBack pain is a major health problem and many sufferers develop persistent symptoms. Detecting relevant subgroups of patients with non-specific low back pain has been highlighted as a priority area for research, as this could enable better secondary prevention through the targeting of prognostic indicators for persistent, disabling symptoms. We plan to conduct a randomised controlled trial to establish whether subgrouping using a novel tool, combined with targeted treatment, is better than best current care at reducing long-term disability from low back pain. METHODS/
designWe will recruit 800 participants aged 18 years and over with non-specific low back pain from 8-10 GP practices within two Primary Care Trusts in Staffordshire, England. Our primary outcome measures are low back pain disability and catastrophising. Secondary outcomes include back pain intensity, global change, leg pain, fear avoidance, anxiety, depression, illness perceptions, patient satisfaction, overall health status and cost-effectiveness. Data will be collected before randomisation, and 4 and 12 months later. Participants are randomised to receive either newly developed interventions, delivered by trained physiotherapists and targeted according to subgroups defined by tool scores, or best current care. DISCUSSION: This paper presents detail on the rationale, design, methods and operational aspects of the trial.
trial registrationCurrent Controlled Trials ISRCTN37113406.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.