The prognostic ability of the STarT Back Tool was affected by episode duration

Purpose: The prognostic ability of the STarT Back Tool (SBT) reportedly varies, but the factors affecting this are unclear. This study investigated the influences of care setting (chiropractic, GP, physiotherapy, spine centre), episode duration (0–2, 3–4, 4–12, > 12 weeks), and outcome time...

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Main Authors: Morso, L., Kongsted, A., Hestbaek, L., Kent, Peter
Format: Journal Article
Published: Springer 2016
Online Access:http://hdl.handle.net/20.500.11937/54844
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author Morso, L.
Kongsted, A.
Hestbaek, L.
Kent, Peter
author_facet Morso, L.
Kongsted, A.
Hestbaek, L.
Kent, Peter
author_sort Morso, L.
building Curtin Institutional Repository
collection Online Access
description Purpose: The prognostic ability of the STarT Back Tool (SBT) reportedly varies, but the factors affecting this are unclear. This study investigated the influences of care setting (chiropractic, GP, physiotherapy, spine centre), episode duration (0–2, 3–4, 4–12, > 12 weeks), and outcome time period (3, 6, 12 months) on SBT prognostic ability. Methods: This was a secondary analysis of data from three primary care cohorts [chiropractic (n = 416), GP (n = 265), and physiotherapy (n = 200) practices] and one cohort from a secondary care outpatient spine centre (n = 974) in Denmark. Care pathways were not systematically affected by SBT risk subgroup (non-stratified care). Using generalised estimating equations, we investigated statistical interactions between SBT risk subgroups and potentially influential factors on the prognostic ability of the SBT subgroups, when Roland Morris Disability Questionnaire scores were the outcome. Results: SBT risk subgroup, age, care setting, and episode duration were all independent prognostic factors. The only investigated factor that modified the prognostic ability of the SBT subgroups was episode duration. Conclusions: These results indicate that the prognostic ability of the SBT in these non-stratified care settings was unaffected by care setting on its own. However, the prognosis of patients is affected by diverse clinical characteristics that differ between patient populations, many of which are not assessed by the SBT. When controlling for some of those factors and testing potential interactions, the results showed that only episode duration affected the SBT prognostic ability and, specifically, that the SBT was less predictive in very acute patients ( < 2 weeks duration).
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spelling curtin-20.500.11937-548442017-09-13T16:11:34Z The prognostic ability of the STarT Back Tool was affected by episode duration Morso, L. Kongsted, A. Hestbaek, L. Kent, Peter Purpose: The prognostic ability of the STarT Back Tool (SBT) reportedly varies, but the factors affecting this are unclear. This study investigated the influences of care setting (chiropractic, GP, physiotherapy, spine centre), episode duration (0–2, 3–4, 4–12, > 12 weeks), and outcome time period (3, 6, 12 months) on SBT prognostic ability. Methods: This was a secondary analysis of data from three primary care cohorts [chiropractic (n = 416), GP (n = 265), and physiotherapy (n = 200) practices] and one cohort from a secondary care outpatient spine centre (n = 974) in Denmark. Care pathways were not systematically affected by SBT risk subgroup (non-stratified care). Using generalised estimating equations, we investigated statistical interactions between SBT risk subgroups and potentially influential factors on the prognostic ability of the SBT subgroups, when Roland Morris Disability Questionnaire scores were the outcome. Results: SBT risk subgroup, age, care setting, and episode duration were all independent prognostic factors. The only investigated factor that modified the prognostic ability of the SBT subgroups was episode duration. Conclusions: These results indicate that the prognostic ability of the SBT in these non-stratified care settings was unaffected by care setting on its own. However, the prognosis of patients is affected by diverse clinical characteristics that differ between patient populations, many of which are not assessed by the SBT. When controlling for some of those factors and testing potential interactions, the results showed that only episode duration affected the SBT prognostic ability and, specifically, that the SBT was less predictive in very acute patients ( < 2 weeks duration). 2016 Journal Article http://hdl.handle.net/20.500.11937/54844 10.1007/s00586-015-3915-0 Springer restricted
spellingShingle Morso, L.
Kongsted, A.
Hestbaek, L.
Kent, Peter
The prognostic ability of the STarT Back Tool was affected by episode duration
title The prognostic ability of the STarT Back Tool was affected by episode duration
title_full The prognostic ability of the STarT Back Tool was affected by episode duration
title_fullStr The prognostic ability of the STarT Back Tool was affected by episode duration
title_full_unstemmed The prognostic ability of the STarT Back Tool was affected by episode duration
title_short The prognostic ability of the STarT Back Tool was affected by episode duration
title_sort prognostic ability of the start back tool was affected by episode duration
url http://hdl.handle.net/20.500.11937/54844