Validity and Reproducibility of the STarT Back Tool (Dutch Version) in Patients With Low Back Pain in Primary Care Settings
Validity and Reproducibility of the STarT Back Tool (Dutch Version) in Patients With Low Back Pain in Primary Care Settings
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DOI：
10.1093/ptj/pzx023
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发表时间：
2017-05-01
期刊：
影响因子：
3.2
通讯作者：
Verhagen, Arianne P.
中科院分区：
文献类型：
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作者：
Bier, Jasper D.;Ostelo, Raymond W. J. G.;Verhagen, Arianne P.
Objective.本研究的目的是翻译和调查STarT背部筛查工具（SBT）的可靠性和有效性，在初级保健环境中的非特异性腰痛（LBP）患者。SBT经过多步骤的向前和向后翻译后被正式翻译成荷兰语。全科医生和物理治疗师包括LBP患者。患者完成了基线问卷调查，并在3天和3个月时进行了随访。用Pearson相关系数计算结构效度。使用二次加权kappa和特异性一致率评估重现性。使用3个月时持续残疾的相对风险比评估预测有效性。内容效度采用天花板效应和地板效应进行分析。共纳入184例患者; 52.2%被归类为“低风险”亚组，38.0%为“中等风险“，9.8%为“高风险”。“对于结构效度，我们发现，正如预期的那样，问题3至9的皮尔逊相关性为中度至高度，问题1和2与各自的参考问卷的相关性较低。重复性的二次加权kappa值为0.65，“低风险“的特异性一致率为82.4%，“中等风险“为53.3%，“高风险”为33.3%。对于持续残疾的预测有效性，我们发现与“低风险“相比，“中风险“的相对风险比为1.8（95%置信区间[CI]：1.0-3.1），“高风险“的相对风险比为2.7（95% CI：1.4-4.9）。“对于内容效度，我们发现不存在下限和上限效应。重测信度研究的样本量相对较小。没有比较物理治疗师和GP之间的患者，因为两组都没有足够的患者。出于实际原因，患者在接受首次治疗/咨询后填写基线问卷;然而，问卷应在首次咨询/治疗前填写。结论。SBT已成功翻译成荷兰语。心理测量学分析表明，可以接受的结果，因此，SBT是一个有效的筛选工具，在荷兰的初级保健与LBP患者。
Objective. The purpose of this study was to translate and to investigate the reliability and validity of the STarT Back screening tool (SBT) in the primary care setting among patients with nonspecific low back pain (LBP).Design. The SBT was formally translated into Dutch following a multistep approach for forward and backward translation. General practitioners and physical therapists included patients with LBP.Methods. Patients completed a baseline questionnaire and a follow-up at 3 days and 3 months. The construct validity was calculated with Pearson's correlation coefficient. The reproducibility was assessed using the quadratic weighted kappa and the specific agreement. Predictive validity was assessed using relative risk ratios for persisting disability at 3 months. Content validity was analyzed using floor and ceiling effects.Results. In total, 184 patients were included; 52.2% were categorized in the "low-risk" subgroup, 38.0% "medium-risk,"and 9.8% "high-risk."For the construct validity we found, as expected, a moderate to high Pearson's correlation for questions 3 to 9 and a low correlation for questions 1 and 2 with their respective reference questionnaires. The reproducibility had a quadratic weighted kappa of 0.65 and the specific agreement of 82.4% for "low-risk,"53.3% for "medium-risk,"and 33.3% for "high-risk."For the predictive validity for persisting disability we found a relative risk ratio for "medium-risk"of 1.8 (95% confidence interval [CI]: 1.0-3.1) and 2.7 (95% CI: 1.4-4.9) for "high-risk"compared with "low-risk."For the content validity, we found that no floor and ceiling effects were present.Limitations. There was a relatively small sample size for the retest reliability study. Patients were not compared between physical therapist and GP, as there were not enough patients in both groups. For practical reasons, the patients filled out the baseline questionnaire after receiving the first treatment/consultation; however, the questionnaire is intended to be filled in before the first consultation/treatment.Conclusion. The SBT has been successfully translated into Dutch. The psychometric analysis showed acceptable results and, therefore, the SBT is a valid screening tool for patients with LBP in Dutch primary care.