BishtRef
Articles Journals Publishers Authors Subjects Most Cited New Papers Year Stats Open Access
journal article Apr 25, 2008

A primary care back pain screening tool: Identifying patient subgroups for initial treatment

Jonathan C. Hill Kate M. Dunn Martyn Lewis Ricky Mullis Chris J. Main Nadine E. Foster Elaine M. Hay
Arthritis Care & Research Vol. 59 No. 5 pp. 632-641 · Wiley
View at Publisher Save 10.1002/art.23563
Abstract
AbstractObjectiveTo develop and validate a tool that screens for back pain prognostic indicators relevant to initial decision making in primary care.MethodsThe setting was UK primary care adults with nonspecific back pain. Constructs that were independent prognostic indicators for persistence were identified from secondary analysis of 2 existing cohorts and published literature. Receiver operating characteristic curve analysis identified single screening questions for relevant constructs. Psychometric properties of the tool, including concurrent and discriminant validity, internal consistency, and repeatability, were assessed within a new development sample (n = 131) and tool score cutoffs were established to enable allocation to 3 subgroups (low, medium, and high risk). Predictive and external validity were evaluated within an independent external sample (n = 500).ResultsThe tool included 9 items: referred leg pain, comorbid pain, disability (2 items), bothersomeness, catastrophizing, fear, anxiety, and depression. The latter 5 items were identified as a psychosocial subscale. The tool demonstrated good reliability and validity and was acceptable to patients and clinicians. Patients scoring 0–3 were classified as low risk, and those scoring 4 or 5 on a psychosocial subscale were classified as high risk. The remainder were classified as medium risk.ConclusionWe validated a brief screening tool, which is a promising instrument for identifying subgroups of patients to guide the provision of early secondary prevention in primary care. Further work will establish whether allocation to treatment subgroups using the tool, linked with targeting treatment appropriately, improves patient outcomes.
Topics

No keywords indexed for this article. Browse by subject →

References
52
[3]
Low Back Pain

Richard A. Deyo, James N. Weinstein

New England Journal of Medicine 10.1056/nejm200102013440508
[7]
Royal College of General Practitioners (1999)
[8]
Jellema P "Prediction of an unfavourable course of low back pain in general practice: comparison of four instruments" Br J Gen Pract (2007)
[28]
The cost of dichotomising continuous variables

Douglas G Altman, Patrick Royston

BMJ 10.1136/bmj.332.7549.1080
[29]
Quality criteria were proposed for measurement properties of health status questionnaires

Caroline B. Terwee, Sandra D.M. Bot, Michael R. de Boer et al.

Journal of Clinical Epidemiology 10.1016/j.jclinepi.2006.03.012
[30]
DunnKM.Epidemiology of low back pain in primary care: a cohort study of consulters. PhD Thesis. Keele: Keele University;2004.
[32]
Kori SH "Kinisophobia: a new view of chronic pain behavior" Pain Manag (1990)
[33]
The Pain Catastrophizing Scale: Development and validation.

Michael J. L. Sullivan, Scott R. Bishop, Jayne Pivik

Psychological Assessment 10.1037/1040-3590.7.4.524
[34]
The Patient Health Questionnaire-2

Kurt Kroenke, Robert L. Spitzer, Janet B. W. Williams

Medical Care 10.1097/01.mlr.0000093487.78664.3c
[45]
The Hospital Anxiety and Depression Scale

A. S. Zigmond, R. P. Snaith

Acta Psychiatrica Scandinavica 10.1111/j.1600-0447.1983.tb09716.x
[46]
Cohen J (1998)
[47]
Bouter LM Spine (2003)
[49]
Mason V (1994)

Showing 50 of 52 references

Cited By
894
Impact of different acute low back pain definitions on the predictors and on the risk of transition to chronic low back pain: a prospective longitudinal cohort study

Rachael O. Osagie, Iulia Tufa · 2025

Pain
Validation of the Keele STarT MSK Tool for Patients With Musculoskeletal Pain in United States-based Outpatient Physical Therapy Settings

Jason M. Beneciuk, Lori A. Michener · 2024

The Journal of Pain
Effect of Acupuncture on Neurogenic Claudication Among Patients With Degenerative Lumbar Spinal Stenosis

Lili Zhu, Yuanjie Sun · 2024

Annals of Internal Medicine
Process evaluation of a complex workplace intervention to prevent musculoskeletal pain in nursing staff: results from INTEVAL_Spain

Mercè Soler-Font, José María Ramada · 2021

BMC Nursing
Stratified primary care versus non-stratified care for musculoskeletal pain: findings from the STarT MSK feasibility and pilot cluster randomized controlled trial

J. C. Hill, S. Garvin · 2020

BMC Family Practice
Psychometric Evaluation of the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) Tool: Factor Structure, Reliability, and Validity

Katie A. Butera, Steven Z. George · 2020

The Journal of Pain
A conceptual framework for prognostic research

Peter Kent, Carol Cancelliere · 2020

BMC Medical Research Methodology
Prevention and management of musculoskeletal pain in nursing staff by a multifaceted intervention in the workplace: design of a cluster randomized controlled trial with effectiveness, process and economic evaluation (INTEVAL_Spain)

Consol Serra, Mercè Soler-Font · 2019

BMC Public Health
Prevention and treatment of low back pain: evidence, challenges, and promising directions

Nadine E Foster, Johannes R Anema · 2018

The Lancet
Low back pain

Johan W. S. Vlaeyen, Chris G. Maher · 2018

Nature Reviews Disease Primers
A Mechanism-Based Approach to Physical Therapist Management of Pain

Ruth L Chimenti, Laura A Frey-Law · 2018

Physical Therapy
Pragmatic Implementation of a Stratified Primary Care Model for Low Back Pain Management in Outpatient Physical Therapy Settings: Two-Phase, Sequential Preliminary Study

Jason M. Beneciuk, Steven Z. George · 2015

Physical Therapy
Development of a Short Form of the Örebro Musculoskeletal Pain Screening Questionnaire

Steven J. Linton, Michael Nicholas · 2011

SPINE
Metrics
894
Citations
52
References
Details
Published
Apr 25, 2008
Vol/Issue
59(5)
Pages
632-641
License
View
Authors
J
Jonathan C. Hill
K
Kate M. Dunn
M
Martyn Lewis

School of Medicine Keele University Keele UK

R
Ricky Mullis

Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

C
Chris J. Main
N
Nadine E. Foster
E
Elaine M. Hay
Cite This Article
Jonathan C. Hill, Kate M. Dunn, Martyn Lewis, et al. (2008). A primary care back pain screening tool: Identifying patient subgroups for initial treatment. Arthritis Care & Research, 59(5), 632-641. https://doi.org/10.1002/art.23563
Related

You May Also Like

Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short‐Form McGill Pain Questionnaire (SF‐MPQ), Chronic Pain Grade Scale (CPGS), Short Form‐36 Bodily Pain Scale (SF‐36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)

Gillian A. Hawker, Samra Mian · 2011

3,213 citations

The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity

Frederick Wolfe, Daniel J. Clauw · 2010

3,156 citations

2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee

Sharon L. Kolasinski, Tuhina Neogi · 2020

1,351 citations

The Rasch measurement model in rheumatology: What is it and why use it? When should it be applied, and what should one look for in a Rasch paper?

Alan Tennant, Philip G. Conaghan · 2007

1,251 citations

American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis

Bevra H. Hahn, Maureen A. McMahon · 2012

1,232 citations