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The following is a summary of “Predictive validity of the STarT Back screening tool among older adults with back pain,” published in the May 2024 issue of Pain by Vigdal et al.

Uncertainties surround the STarT Back tool’s ability to predict chronic back pain in older adults.

Researchers conducted a retrospective study in primary care older adults to evaluate the SBT’s ability to predict chronic back pain.

They involved 452 patients aged ≥55 years who sought Norwegian primary care for a new episode of back pain. A poor outcome (persistent disabling back pain) was defined as a score of ≥7/24 on the Roland-Morris Disability Questionnaire (RMDQ) at 3, 6, or 12 months of follow-up. Multivariable logistic regression, the area under the receiver operating characteristics curve (AUC), and accuracy measures (sensitivity, specificity, predictive values, and likelihood ratios) were used to assess the ability of the SBT risk groups to identify persistent disabling back pain.

The results showed that the disabling back pain was 2.40 (1.34–4.30) at 3 months, 3.42 (1.76–6.67) at 6 months, and 2.81 (1.47–5.38) at 12 months for the medium-risk group (n = 118) with a aORs (95% CI). For the high-risk group (n = 27), the ORs were 8.90 (1.83–43.24) at 3 months, 2.66 (0.81–8.67) at 6 months, and 4.53 (1.24–16.46) at 12 months, compared to the low-risk group (n = 282). No significant differences in odds were found between medium- and high-risk groups. The AUC values (95% CI) were 0.65 (0.59–0.71) at 3 months, 0.67 (0.60–0.73) at 6 months, and 0.65 (0.58–0.71) at 12 months. Accuracy measures were poor across all time points, with poor sensitivity and negative likelihood ratio values.

Investigators concluded the SBT risk groups did not accurately predict long-term, disabling back pain in older adults.

Source: onlinelibrary.wiley.com/doi/full/10.1002/ejp.2281