Trial reportThe journal of pain2017
Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis.
Trial report in The journal of pain, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 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
20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 4 citations in OpenAlex.
- 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
- The strength of association between psychological factors and clinical outcome in tendinopathy: A systematic review.PloS one · 2020Pooled it
- Individual recovery expectations and prognosis of outcomes in non-specific low back pain: prognostic factor review.The Cochrane database of systematic reviews · 2019Pooled it
- Pooled it
- Effect Modifiers of Graded Sensorimotor Retraining for Chronic Low Back Pain: A Secondary Analysis of the RESOLVE Randomized Trial.JAMA network open · 2026Trial
- Potential effect modifiers for treatment with chiropractic manipulation versus sham manipulation for recurrent headaches in children aged 7-14 years: development of and results from a secondary analysis of a randomised clinical trial.Chiropractic & manual therapies · 2023Trial
- Potential treatment effect modifiers for manipulative therapy for children complaining of spinal pain.Secondary analyses of a randomised controlled trial.Chiropractic & manual therapies · 2019Trial
- The heterogeneous effect of short-term transfers for improving ART adherence among HIV-infected Tanzanian adultsAIDS care · 2018Trial
- Empowering Self-Management of Chronic Low Back Pain Among Spanish and Cantonese Speakers in the United States.Cureus · 2025Article
- An Early Biopsychosocial Intervention Design for the Prevention of Low Back Pain Chronicity: A Multidisciplinary Empirical Approach.Journal of rehabilitation medicine · 2022Article
- Article
- Barriers to Building More Effective Treatments: Negative Interactions Amongst Smoking Intervention Components.Clinical psychological science : a journal of the Association for Psychological Science · 2021Article
- Efficacy and acceptability of pharmacological and non-pharmacological interventions for non-specific chronic low back pain: a protocol for a systematic review and network meta-analysis.Systematic reviews · 2020Article
- Treatment monitoring as a component of psychologically informed physical therapy: A case series of patients at high risk for persistent low back pain related disability.Musculoskeletal science & practice · 2019Article
- The use of STarT back screening tool to predict functional disability outcomes in patients receiving physical therapy for low back pain.The spine journal : official journal of the North American Spine Society · 2019Article
- The Impact of Inadequate Health Literacy in a Population with Musculoskeletal Pain.Health literacy research and practice · 2018Article
- Advancing Psychologically Informed Practice for Patients With Persistent Musculoskeletal Pain: Promise, Pitfalls, and Solutions.Physical therapy · 2018Review
- The STarT back tool in chiropractic practice: a narrative review.Chiropractic & manual therapies · 2017Review
- Framework for improving outcome prediction for acute to chronic low back pain transitions.Pain reportsReview
- Advancing practice for back pain through stratified care (STarT Back).Brazilian journal of physical therapyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
Identification of patient characteristics influencing treatment outcomes is a top low back pain (LBP) research priority. Results from the STarT Back trial support the effectiveness of prognostic stratified care for LBP compared with current best care, however, patient characteristics associated with treatment response have not yet been explored. The purpose of this secondary analysis was to identify treatment effect modifiers within the STarT Back trial at 4-month follow-up (n = 688). Treatment response was dichotomized using back-specific physical disability measured using the Roland-Morris Disability Questionnaire (≥7). Candidate modifiers were identified using previous literature and evaluated using logistic regression with statistical interaction terms to provide preliminary evidence of treatment effect modification. Socioeconomic status (SES) was identified as an effect modifier for disability outcomes (odds ratio [OR] = 1.71, P = .028). High SES patients receiving prognostic stratified care were 2.5 times less likely to have a poor outcome compared with low SES patients receiving best current care (OR = .40, P = .006). Education level (OR = 1.33, P = .109) and number of pain medications (OR = .64, P = .140) met our criteria for effect modification with weaker evidence (.20 > P ≥ .05). These findings provide preliminary evidence for SES, education, and number of pain medications as treatment effect modifiers of prognostic stratified care delivered in the STarT Back Trial. PERSPECTIVE: This analysis provides preliminary exploratory findings about the characteristics of patients who might least likely benefit from targeted treatment using prognostic stratified care for LBP.
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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.