Observational studySchmerz (Berlin, Germany)2018
[Avoidance-endurance fast screening (AE-FS) : Content and predictive validity of a 9‑item screening instrument for patients with unspecific subacute low back pain].
Observational study in Schmerz (Berlin, Germany), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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.
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, 1 synthesis or guideline pooled 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
- [Avoidance-endurance fast screen : AEFS validation with one- and two-level response scaling in healthy subjects].Schmerz (Berlin, Germany) · 2026Article
- Article
- [Graded balance in pain therapy : Risk factor-based approaches based on the avoidance-endurance model].Schmerz (Berlin, Germany) · 2025Review
- Frequencies of persistence, activity pacing, fear avoidance and general stress in acute neck pain.Comprehensive psychoneuroendocrinology · 2025Review
- Persistence, not avoidance, is associated with low back pain-An observational cohort study.European journal of pain (London, England) · 2025Observational
- Prognostic value of activity patterns and stress measures for persistent pain and disability in acute neck pain: a 3-month follow-up study.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- Translation, reliability, and validity of the German version of the Activity Patterns Scale (APS) in musculoskeletal pain: a methodological study.BMC musculoskeletal disorders · 2024Article
- The biobehavioural pain and movement questionnaire (BioPMovQ): development and psychometric validation of a new questionnaire.Frontiers in medicine · 2024Article
- [Psychosocial risk factors for chronic back pain in the general population and in competitive sports : From theory to clinical screening-a review from the MiSpEx network].Schmerz (Berlin, Germany) · 2018Review
- [Interdisciplinary pain psychology II : Risk factors, diagnostic workup, therapy and transfer in clinical practice].Schmerz (Berlin, Germany) · 2018Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAmong screening measures to assess psychosocial risk factors (yellow flags) for chronic low back pain (LBP) economic tools which address dysfunctional endurance pain responses besides emotional distress and fear-avoidance pain processing are rare. Targeting contrasting types of pain processing might improve stratified patient counselling.
objectiveThe aim of the study was to develop a short screening method, based on the avoidance-endurance model of pain and to investigate the prognostic validity for pain intensity, disability and physical function. MATERIAL AND
methodsA prospective observational study was carried out on 144 patients with subacute LBP (<3 months) from 7 general practitioners and 5 orthopedic practices. The 9‑item avoidance-endurance fast screening (AE-FS) was derived from a previous 37-item screening using correlational and receiver operating curve (ROC) analyses and the agreement of subgrouping was calculated using Cohen's kappa. Primary outcomes were assessed after 6 months by mail in 124 patients (86%). Endpoints were pain intensity and disability.
resultsThe classification of subgroups as high and low risk by both measures had considerable agreement with a value of 0.71 (Cohen's Kappa). The sensitivity to predict pain intensity >2 was high (82%) as was the positive predictive value (80%) but the negative predictive value was moderate (61%). The ROC (AUC) characteristics (95% confidence interval CI) were 0.70 (0.60-0.80) for pain intensity and for limitations in the pain disability index (PDI) 0.70 (0.55-0.87). DISCUSSION: The 9‑item AE-FS displayed sufficient prognostic validity for all three outcomes in a sample of primary care patients with subacute LBP. The differentiation of the high-risk patients into fear-avoidance and endurance-related pain processing enables the physician to provide an individualized counselling with the aim of a healthy balance between stress and relaxation.
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Registered trials
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