ReviewChiropractic & manual therapies2017
The STarT back tool in chiropractic practice: a narrative review.
Review in Chiropractic & manual therapies, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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
11 citing papers in PubMed.
- Development and evaluation of the MAINTAIN instrument, selecting patients suitable for secondary or tertiary preventive manual care: the Nordic maintenance care program.Chiropractic & manual therapies · 2022Trial
- Stratified versus usual care for the management of primary care patients with sciatica: the SCOPiC RCT.Health technology assessment (Winchester, England) · 2020Trial
- Effects of spinal manipulative therapy biomechanical parameters on clinical and biomechanical outcomes of participants with chronic thoracic pain: a randomized controlled experimental trial.BMC musculoskeletal disorders · 2019Trial
- Distribution of prognostic subgroups, assessed by STarT Back Screening Tool, in Veterans with low back pain receiving on-site chiropractic care: a cross-sectional chart review.The Journal of the Canadian Chiropractic Association · 2026Article
- Evaluation of chiropractic students' perspectives on back pain management following one of three clinical evidence-based educational training interventions: a cluster-randomized trial.The Journal of the Canadian Chiropractic Association · 2025Article
- Prognostic ability of the sTarT back screening tool for disability and pain intensity outcomes in older adults with low back pain seeking chiropractic care: a multi-national external validation study.Chiropractic & manual therapies · 2025Article
- Predictors of response in PROMIS-global in a chronic low back pain specialty clinic: STarTBack and chronic overlapping pain conditions.Journal of back and musculoskeletal rehabilitation · 2024Observational
- Exploring pain phenotypes in workers with chronic low back pain: Application of IMMPACT recommendations.Canadian journal of pain = Revue canadienne de la douleur · 2021Article
- A descriptive analysis of clinical application of patient-reported outcome measures and screening tools for low back pain patients in US chiropractic teaching institutions.The Journal of chiropractic education · 2021Article
- Professional barriers and facilitators to using stratified care approaches for managing non-specific low back pain: a qualitative study with Canadian physiotherapists and chiropractors.Chiropractic & manual therapies · 2019Article
- Measuring biopsychosocial risk for back pain disability in chiropractic patients using the STarT back screening tool: a cross-sectional survey.Chiropractic & manual therapies · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Keele STarT Back Tool was designed for primary care medical physicians in the UK to determine the risk for persistent disabling pain in patients with musculoskeletal pain and to tailor treatments accordingly. In medical and physical therapy settings, STarT Back Tool's tailored care plans improved patients' low back pain outcomes and lowered costs.
objectiveReview studies using the STarT Back Tool in chiropractic patient populations.
methodsPubMed, The Cochrane Library, Index to Chiropractic Literature, and Science Direct databases were searched. Articles written in English, published in peer-reviewed journals, that studied the STarT Back Tool in patients seeking chiropractic care were included.
resultsSeven articles were selected based on inclusion and exclusion criteria. The STarT Back Tool was feasibly incorporated into 19 chiropractic clinics in Denmark. Total STarT Back 5-item score correlated moderately with total Bournemouth Questionnaire score. Two studies reported that the STarT Back Tool's predictive ability was poor, while another reported that the tool predicted outcomes in patients scoring in the medium and high risk categories who completed the STarT Back 2 days after their initial visit. A study examining Danish chiropractic, medical and physical therapy settings revealed that only baseline episode duration affected STarT Back's prognostic ability across all care settings. The tool predicted pain and disability in chiropractic patients whose episode duration was at least 2 weeks, but not in patients with an episode duration <2 weeks.
conclusionWhile the STarT Back Tool can be incorporated into chiropractic settings and correlates with some elements of the Bournemouth Questionnaire, its prognostic ability is sometimes limited by the shorter low back pain episodes with which chiropractic patients often present. It may be a better predictor in patients whose episode duration is at least 2 weeks. Studies examining outcomes of stratified care in chiropractic patients are needed.
Indexed as
Identifiers
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.