DOI: 10.1101/19005041Aug 20, 2019Paper

Triage-based care of people with Back Pain: STarT Back or Start diagnosing? An observational study.

MedRxiv : the Preprint Server for Health Sciences
Tim GermonJ. Hobart


Objectives Back pain is a massive public health problem. The STarT Back Screening Tool (SBST) was developed for use in primary care to triage people with lumbar pain, classifying them as low, medium or high risk of prolonged symptoms. This classification guides non-surgical interventions including manual treatments, exercise and cognitive behavioural therapy. Claims suggest SBST brings generic health and cost benefits. National guidance recommends STarT Back is used at the first primary care consultation but can be used at any stage. For SBST to be an effective triage tool it should distinguish structural from non-structural pain. We tested this requirement in consecutive people referred to a single triage practitioner, hypothesising it was not possible conceptually. Design An observational study of the relationship between routine, prospectively collected triage data and diagnosis. Setting A secondary care spinal triage service based in a teaching hospital. Participants We studied consecutive referrals with lumbar pain triaged by a single extended scope practitioner (ESP) over 22 months (Nov 2015-Sept 2017). Main Outcome Measures SBST and pain visual analogue scores (VAS: 0-10) were collected at the initial consultation. We co...Continue Reading

Software Mentioned

STarT Back Screening Tool ( SBST

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