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    The predictive and external validity of the STarT Back Tool in Danish primary care

    Access Status
    Fulltext not available
    Authors
    Morsø, L.
    Kent, Peter
    Albert, H.
    Hill, J.
    Kongsted, A.
    Manniche, C.
    Date
    2013
    Type
    Journal Article
    
    Metadata
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    Citation
    Morsø, L. and Kent, P. and Albert, H. and Hill, J. and Kongsted, A. and Manniche, C. 2013. The predictive and external validity of the STarT Back Tool in Danish primary care. European Spine Journal. 22 (8): pp. 1859-1867.
    Source Title
    European Spine Journal
    DOI
    10.1007/s00586-013-2690-z
    ISSN
    0940-6719
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/54709
    Collection
    • Curtin Research Publications
    Abstract

    Purpose: The STarT Back Tool (SBT) was recently translated into Danish and its concurrent validity described. This study tested the predictive validity of the Danish SBT. Methods: Danish primary care patients (n = 344) were compared to a UK cohort. SBT subgroup validity for predicting high activity limitation at 3 months' follow-up was assessed using descriptive proportions, relative risks, AUC and odds ratios. Results: The SBT had a statistically similar predictive ability in Danish primary care as in UK primary care. Unadjusted relative risks for poor clinical outcome on activity limitation in the Danish cohort were 2.4 (1.7-3.4) for the medium-risk subgroup and 2.8 (1.8-3.8) for the high-risk subgroup versus 3.1 (2.5-3.9) and 4.5 (3.6-5.6) for the UK cohort. Adjusting for confounders appeared to explain the lower predictive ability of the Danish high-risk group. Conclusions: The Danish SBT distinguished between low- and medium-risk subgroups with a similar predictive ability of the UK SBT. That distinction is useful information for informing patients about their expected prognosis and may help guiding clinicians' choice of treatment. However, cross-cultural differences in the SBT psychosocial subscale may reduce the predictive ability of the high-risk subgroup in Danish primary care.

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