Construct and discriminant validity of STarT Back Screening Tool - Brazilian version.
Bruna Pilz, Rodrigo A Vasconcelos, Paulo P Teixeira and 4 others
PMID 28442077WHAT IT FOUND
The Brazilian STarT Back questionnaire agreed with disability scores, but only weakly with fear-avoidance beliefs about work and physical activity.
It can help flag low back pain patients with more disability, not fear beliefs alone.
Key findings
01In 151 low back pain patients, the Brazilian STarT Back total and psychosocial scores agreed with disability scores.
02The same scores agreed weakly with work-related fear-avoidance scores.
03Against established cutoffs, the total score's discrimination was 0.88 and 0.81 for disability and 0.71 and 0.66 for fear avoidance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Patients were recruited conveniently from one private clinic, so results may not apply to other settings. 124 of the 151 participants had university-level education, and the sample had few work-related problems, limiting generalisation to patients with work disability. The study compared questionnaire scores at baseline only; it did not test whether the tool predicts outcomes or changes treatment. The STarT Back tool has no item specific to work fear avoidance, which may explain its weak correlation with the work subscale.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that the Brazilian STarT Back questionnaire measures fear-avoidance beliefs well. Its correlations with the Fear-Avoidance Beliefs Questionnaire were weak, and the study tested scores at one time point, not whether the tool improves treatment outcomes.