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Comparison between the STarT Back Screening Tool and the Örebro Musculoskeletal Pain Screening Questionnaire: Which tool for what purpose? A semi-systematic review - 30/05/19

Doi : 10.1016/j.rehab.2018.09.007 
Alexis Lheureux a, , Anne Berquin b
a Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal lab, Avenue Mounier 53/B1.53.07, 1200 Brussels, Belgium 
b Department of Physical and Rehabilitation Medicine, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10/1650, 1200 Brussels, Belgium 

Corresponding author. Avenue Mounier 53/B1.53.07, 1200 Woluwe-Saint-Lambert, Belgium.Avenue Mounier 53/B1.53.07Woluwe-Saint-Lambert1200Belgium

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Abstract

Background

Prevention of chronicization of low back pain requires accurate detection of at-risk patients. Questionnaires have been validated, including the STarT Back Screening Tool (SBST) and the Örebro Musculoskeletal Pain Screening Questionnaire (OMPSQ). This review aims to compare these questionnaires in terms of predictive value and in terms of aims, to guide the choice in clinical practice.

Methods

This study is a semi-systematic literature review. Studies evaluating at least one of the questionnaires and written between 1997 and October 10th 2017 were selected from Pubmed database. Inclusion criteria were pain duration<3months, outcomes including pain, function and/or global recovery. For work outcomes, inclusion criteria were extended to chronic patients. Studies had to provide information on sensitivity, specificity and area under the ROC Curve (AUC).

Results

Twenty-eight studies met our inclusion criteria (7 SBST, 21 original OMPSQ, 3 short OMPSQ). The OMPSQ best predicted a Pain NRS3 at 3 months (AUC=0.64 (0.50–0.78)) and at 6 months (AUC between 0.70 (no confidence interval provided) and 0.84 (0.71–0.97)). The SBST and the OMPSQ are comparable to predict an Oswestry Disability Index30% at 6 months. A single study showed no difference between the SBST and the OMPSQ to predict absenteeism30 days at 6 months. The two questionnaires cannot be compared for “global recovery” outcomes.

Conclusion

The OMPSQ seems better than the SBST for predicting “pain” and “work” outcomes, the SBST may be better for “function” outcomes. These results should be taken with caution because of the high heterogeneity between studies. It should be noted that the OMPSQ was elaborated with the aim of creating a prognostic tool while the SBST was devised as a treatment-allocating tool and is easier to use in clinical practice. This should guide the choice of using one questionnaire rather than the other.

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Keywords : STarT Back Screening Tool (SBST), Örebro Musculoskeletal Pain Screening Questionnaire (OMPSQ), Low back pain, Predicting questionnaires


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 This semi-systematic review compared 2 prognostic questionnaires about back pain (STarT Back Screening Tool and Örebro Musculoskeletal Pain Screening Questionnaire) in terms of prognostic power and clinical aims, to guide the healthcare provider in choosing a questionnaire. By its large inclusion criteria, our study is the broadest on the topic. Although the 2 questionnaires present good and equivalent predictive power, we highlight important differences between them in clinical objectives and usefulness, which may be the most important to consider when deciding which tool to use.


© 2018  Pubblicato da Elsevier Masson SAS.
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Vol 62 - N° 3

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