Trial reportArchives of physical medicine and rehabilitation2018
Predictive Validity of the STarT Back Tool for Risk of Persistent Disabling Back Pain in a U.S. Primary Care Setting.
Trial report in Archives of physical medicine and rehabilitation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04691193 (The Effect of STarT Back Screening Tool in Determining Prognosis and Workforce Loss in Patients With Acute-Subacute Low Back Pain and Its Relationship With Kinesiophobia), which is not on this map. Cited by 22 papers.
What it found
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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.
The Effect of STarT Back Screening Tool in Determining Prognosis and Workforce Loss in Patients With Acute-Subacute Low Back Pain and Its Relationship With Kinesiophobia
Who cites it
22 citing papers in PubMed, 44 citations in OpenAlex.
- Feasibility and long-term efficacy of a proactive health program in the treatment of chronic back pain: a randomized controlled trial.BMC health services research · 2019Trial
- Prognostic ability of the German version of the STarT Back tool: analysis of 12-month follow-up data from a randomized controlled trial.BMC musculoskeletal disorders · 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
- 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
- Efficiency of telephone triage in the assessment of low back pain at a tertiary spine clinic.BMC musculoskeletal disorders · 2025Observational
- Observational
- 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
- Development and Implementation of MyPainHub, a Web-Based Resource for People With Musculoskeletal Conditions and Their Health Care Professionals: Mixed Methods Study.JMIR formative research · 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
- A descriptive analysis of the contents of Care Response, an international data set of patient-reported outcomes for chiropractic patients.Chiropractic & manual therapies · 2023Article
- Article
- Risk Stratification in a Tertiary Care Spine Centre: Comparison Between STarTBack and OSPRO-YF Screening Tools.Physiotherapy Canada. Physiotherapie Canada · 2023Article
- Management of Low Back Pain: Do Physiotherapists Know the Evidence-Based Guidelines?International journal of environmental research and public health · 2023Article
- A Scoping Review of Chronic Low Back Pain Classification Schemes Based on Patient-Reported Outcomes.Pain physician · 2022Article
- Article
- An interactive e-learning module to promote bio-psycho-social management of low back pain in healthcare professionals: a pilot study.The Journal of manual & manipulative therapy · 2022Article
- Adding Physical Impairment to Risk Stratification Improved Outcome Prediction in Low Back Pain.Physical therapy · 2021Observational
- Artificial intelligence to improve back pain outcomes and lessons learnt from clinical classification approaches: three systematic reviews.NPJ digital medicine · 2020Review
- The Evolving Case Supporting Individualised Physiotherapy for Low Back Pain.Journal of clinical medicine · 2019Review
- 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
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo examine the predictive validity of the Subgrouping for Targeted Treatment (STarT Back) tool for classifying people with back pain into categories of low, medium, and high risk of persistent disabling back pain in U.S. primary care.
designSecondary analysis of data from participants receiving usual care in a randomized clinical trial.
settingPrimary care clinics.
participantsAdults (N = 1109) ≥18 years of age with back pain. Those with specific causes of back pain (pregnancy, disc herniation, vertebral fracture, spinal stenosis) and work-related injuries were not included.
interventionsNot applicable.
main outcome measuresThe original 9-item version of the STarT Back tool, administered at baseline, stratified patients by their risk (low, medium, high) of persistent disabling back pain (STarT Back risk group). Persistent disabling back pain was defined as Roland-Morris Disability Questionnaire scores of ≥7 at 6-month follow-up.
resultsThe STarT Back risk group was a significant predictor of persistent disabling back pain (P<.0001) at 6-month follow-up. The proportion of individuals with persistent disabling back pain at follow-up was 22% (95% confidence interval [CI] 18-25) in the low-risk group, 62% (95% CI 57-67) in the medium-risk group, and 80% (95% CI 75-85) in the high-risk group. The relative risk of persistent disabling back pain was 2.9 (95% CI 2.4-3.5) in the medium-risk group compared to the low-risk group, and 3.7 (95% CI 3.1-4.4) in the high-risk group.
conclusionsThe STarT Back risk groups successfully separated people with back pain into distinct categories of risk for persistent disabling back pain at 6-month follow-up in U.S. primary care. These results were very similar to those in the original STarT Back validation study. This validation study is a necessary first step toward identifying whether the entire STarT Back approach, including matched/targeted treatment, can be effectively used for primary care in the United States.
Indexed as
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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.