Predictive Validity of the STarT Back Tool for Risk of Persistent Disabling Back Pain in a U.S. Primary Care Setting.
Predictive Validity of the STarT Back Tool for Risk of Persistent Disabling Back Pain in a U.S. Primary Care Setting.
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DOI：
10.1016/j.apmr.2018.02.016
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发表时间：
2018-08
影响因子：
4.3
通讯作者：
Cherkin DC
中科院分区：
文献类型：
--
作者：
Suri P;Delaney K;Rundell SD;Cherkin DC
在美国初级保健中，检查STartT背部工具用于将背痛患者分类为持续性致残性背痛低、中、高风险类别的预测有效性。随机临床试验中接受常规治疗的受试者数据的次要分析。初级保健诊所。1109例≥18岁的背痛成人。那些有特定原因的背痛（怀孕，椎间盘突出，脊椎骨折，椎管狭窄）和工伤不包括在内。N/A STarT背部工具的原始9项版本，在基线时使用，根据患者持续致残性背部疼痛的风险（低、中、高）（“STarT背部风险组”）对患者进行分层。持续性致残性背痛定义为6个月随访时Roland-Morris残疾问卷评分≥7。STarT背部风险组是6个月随访时持续性致残性背部疼痛的重要预测因素（p<0.0001）。随访时，低风险组中持续致残性背痛的个体比例为22%（95%置信区间[CI] 18-25%），中等风险组为62%（95% CI 57-67%），高风险组为80%（95% CI 75-85%）。与低风险组相比，中风险组中持续性致残性背痛的相对风险为2.9（95% CI 2.4-3.5），高风险组中为3.7（95% CI 3.1-4.4）。我们发现，在美国初级保健6个月随访时，STartT背部风险组成功地将背痛患者分为持续致残性背痛的不同风险类别。这些结果与原始STarT Back确认研究中观察到的结果非常相似。这项验证研究是确定整个STarT Back方法（包括匹配/靶向治疗）是否可有效用于美国初级保健的必要第一步。
To examine the predictive validity of the STarT Back tool for classifying people with back pain into categories of low, medium, and high risk of persistent disabling back pain, in US primary care. Secondary analysis of data from participants receiving usual care in a randomized clinical trial. Primary care clinics. 1109 adults with back pain ≥18 years of age. Those with specific causes of back pain (pregnancy, disc herniation, vertebral fracture, spinal stenosis) and work-related injuries were not included. N/A The 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. STarT Back risk group was a significant predictor of persistent disabling back pain (p<0.0001) 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 as compared to the low-risk group, and 3.7 (95% CI 3.1–4.4) in the high-risk group. We found that the 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 US primary care. These results were very similar to those seen in the original STarT Back validation study. This validation study is a necessary first step towards identifying whether the entire STarT Back approach, including matched/targeted treatment, can be effectively used for primary care in the US.
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影响因子：
3.2
作者：
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通讯作者：
Verhagen, Arianne P.
影响因子：
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通讯作者：
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影响因子：
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作者：
PATRICK, DL;DEYO, RA;KELLER, RB
通讯作者：
KELLER, RB