Comparison between the STarT Back Screening Tool and the Örebro Musculoskeletal Pain Screening Questionnaire: Which tool for what purpose? A semi-systematic review

Abstract Objective To systematically review the accuracy and characteristics of different questionnaire-based PsA screening tools. Methods A systematic review of MEDLINE, Excerpta Medical Database, Cochrane Central Register of Controlled Trials and Web of Science was conducted to identify studies that evaluated the accuracy of self-administered PsA screening tools for patients with psoriasis. A bivariate meta-analysis was used to pool screening tool-specific accuracy estimates (sensitivity and specificity). Heterogeneity of the diagnostic odds ratio was evaluated through meta-regression. All full-text records were assessed for risk of bias with the QUADAS 2 tool. Results A total of 2280 references were identified and 130 records were assessed for full-text review, of which 42 were included for synthesis. Of these, 27 were included in quantitative syntheses. Of the records, 37% had an overall low risk of bias. Fourteen different screening tools and 104 separate accuracy estimates were identified. Pooled sensitivity and specificity estimates were calculated for the Psoriatic Arthritis Screening and Evaluation (cut-off = 44), Psoriatic Arthritis Screening and Evaluation (47), Toronto Psoriatic Arthritis Screening (8), Psoriasis Epidemiology Screening Tool (3) and Early Psoriatic Arthritis Screening Questionnaire (3). The Early Psoriatic Arthritis Screening Questionnaire reported the highest sensitivity and specificity (0.85 each). The I2 for the diagnostic odds ratios varied between 76 and 90.1%. Meta-regressions were conducted, in which the age, risk of bias for patient selection and the screening tool accounted for some of the observed heterogeneity. Conclusions Questionnaire-based tools have moderate accuracy to identify PsA among psoriasis patients. The Early Psoriatic Arthritis Screening Questionnaire appears to have slightly better accuracy compared with the Toronto Psoriatic Arthritis Screening, Psoriasis Epidemiology Screening Tool and Psoriatic Arthritis Screening and Evaluation. An economic evaluation could model the uncertainty and estimate the cost-effectiveness of PsA screening programs that use different tools.

Download Full-text

Translation validation of a new back pain screening questionnaire (the STarT Back Screening Tool) in French

Archives of Public Health ◽

10.1186/0778-7367-70-12 ◽

2012 ◽

Vol 70 (1) ◽

Cited By ~ 35

Author(s):

Olivier Bruyère ◽

Maryline Demoulin ◽

Clara Brereton ◽

Fabienne Humblet ◽

Daniel Flynn ◽

...

Keyword(s):

Back Pain ◽

Screening Tool ◽

Screening Questionnaire ◽

Start Back Screening Tool ◽

Translation Validation

Download Full-text

An evaluation of the psychometric properties of the STarT Back Screening Tool—a systematic review

Physiotherapy ◽

10.1016/j.physio.2015.03.1799 ◽

2015 ◽

Vol 101 ◽

pp. e948-e949 ◽

Cited By ~ 2

Author(s):

D. Kenny ◽

J. Ball ◽

C. Bloxham ◽

G. Cashmore ◽

F. Dick ◽

...

Keyword(s):

Systematic Review ◽

Psychometric Properties ◽

Screening Tool ◽

Start Back Screening Tool

Download Full-text

Preliminary Evaluation of a Modified STarT Back Screening Tool Across Different Musculoskeletal Pain Conditions

Physical Therapy ◽

10.2522/ptj.20150377 ◽

2016 ◽

Vol 96 (8) ◽

pp. 1251-1261 ◽

Cited By ~ 13

Author(s):

Katie A. Butera ◽

Trevor A. Lentz ◽

Jason M. Beneciuk ◽

Steven Z. George

Keyword(s):

Depressive Symptoms ◽

Health Status ◽

Pain Intensity ◽

Musculoskeletal Pain ◽

Knee Pain ◽

Screening Tool ◽

Low Back ◽

Fear Avoidance ◽

Start Back Screening Tool ◽

Dependent Variables

Abstract Background The STarT Back Screening Tool is a validated multidimensional screening measure and risk stratification tool for people with low back pain. Objective The study objective was to compare relationships between a modified STarT Back Screening Tool (mSBT) and clinical and psychological measures in people with low back, neck, shoulder, and knee pain. The hypothesis was that the relationships between mSBT scores and clinical and psychological measure scores would be similar across the included musculoskeletal pain conditions. Design A cross-sectional, secondary analysis was done in this study. Methods Participants with low back (n=118), neck (n=92), shoulder (n=106), or knee (n=111) pain were recruited, and an mSBT was developed for use across the pain conditions. Separate hierarchical linear regression models were developed, with clinical (health status, pain intensity, and disability) and psychological (kinesiophobia, catastrophizing, fear avoidance, anxiety, depressive symptoms, and self-efficacy) measures as dependent variables. Demographic and pain region variables were entered in the first step, mSBT scores were entered in the second step, and pain region × mSBT interactions were entered in the last step. Results In the final models, no interactions were identified, suggesting that dependent measure scores did not differ by pain region. The strongest contributor for all dependent variables was mSBT scores (β=|0.32|–|0.68|); higher mSBT scores were associated with poorer health status and self-efficacy and with higher levels of pain intensity, disability, kinesiophobia, catastrophizing, fear avoidance, anxiety, and depressive symptoms. Limitations Generalizability was restricted to physical therapy outpatients with the included pain conditions. The mSBT used in this study is not ready for clinical implementation. Conclusions The results of this study support the feasibility of using a single measure for concise risk assessment across different musculoskeletal pain conditions. Further longitudinal studies are needed to better direct the clinical use of an mSBT in people with low back, neck, shoulder, and knee pain.

Download Full-text