Validity and reproducibility of the modified STarT Back Tool (Dutch version) for patients with neck pain in primary care

Jasper D. Bier*, Raymond W.J.G. Ostelo, Bart W. Koes, Arianne P. Verhagen

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

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Abstract

Objective To evaluate the reliability and validity of the Dutch version of the STarT Back screening Tool (SBT), for patients with neck pain. Methods We modified the SBT to fit patients with neck pain. General practitioners and physiotherapists included patients who completed both a baseline and a follow-up questionnaire at 3 days and 3 months, respectively. The construct validity was assessed using Pearson's correlation between the SBT and the reference questionnaires. The reproducibility was assessed in the first week using the quadratic weighted kappa and the specific agreement. Predictive validity was assessed using a relative-risk ratio (RR) for, amongst others, persisting disability at 3 months. Content validity was analysed using both floor and ceiling effects. Results In total, 100 patients were included; 58% were categorised as being at “low risk” for persisting disability, 37% at “medium risk” and 5% at “high risk”. As expected for the construct validity, we found a moderate to high correlation for all questions except for activity question 3. The reproducibility had a quadratic-weighted kappa of 0.58, and a specific agreement of 90.9% for “low-risk” and 66.7% for “medium-risk” patients. The RRs for persisting disability for “medium-risk” against “low-risk” patients were 1.5 (95% C.I. 0.9–2.4) and 1.5 (95% C.I. 0.5–4.1) for pain. The sample size for high-risk patients was low. Conclusion The original SBT is modified to fit patients with neck pain in Dutch primary care. The psychometric analysis indicates sufficiently reliable outcomes, although the predictive validity showed statistically insignificant results.

Original languageEnglish
Pages (from-to)22-29
Number of pages8
JournalMusculoskeletal Science and Practice
Volume31
Early online date15 Jun 2017
DOIs
Publication statusPublished - Oct 2017

Funding

This study was undertaken with financial support from the CZ healthcare insurance company and the Dutch Arthritis Foundation .

FundersFunder number
CZ healthcare insurance company
Dutch Arthritis Foundation

    Keywords

    • Classification
    • GP
    • Neck pain
    • Physical therapy
    • STarT back-screening tool
    • Validation

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