Risk Stratification in a Tertiary Care Spine Centre: Comparison Between STarTBack and OSPRO-YF Screening Tools.

IF 0.9 4区 医学 Q4 REHABILITATION Physiotherapy Canada Pub Date : 2023-05-01 DOI:10.3138/ptc-2021-0026
Susan Robarts, Helen Razmjou, Albert Yee, Joel Finkelstein
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Abstract

Purpose: STarT Back Screening Tool and OSPRO-YF scales have been reported to be accurate tools for estimating risk for the development of persistent pain or prolonged disability in primary care settings. We performed a comparison of construct convergent and known-group validity and ceiling floor effect (CFE) of these tools using a common sample of patients seen at a tertiary care spine centre.

Methods: This was a cross-sectional study of patients with and without a work-related back injury. The Hospital Anxiety and Depression Scale (HADS) was used as the reference outcome measure for convergent validity. For known-group validity, we examined the ability of the scales to differentiate between different levels of compensation, presence of non-organic signs, and work status. The CFE values were calculated.

Results: Fifty consecutive injured workers were included along with 50 patients without an active compensation claim related to their low back pain. STarTBack and OSPRO-YF had moderate to high associations with the depression component of the HADS (0.69 to 0.77 respectively) with a statistically significant difference in favour of the OSPRO-YF. STarTBack's risk stratification categories were able to differentiate patients with a compensable injury, non-organic signs, and inability to work (p values ranging from 0.002 to < 0.001). The physical activity and work fear-avoidance beliefs constructs of the OSPRO-YF consistently outperformed other yellow flag constructs (p values ranging from 0.008 to < 0.001). The psychological sub-score of STarTBack showed a ceiling effect. There was a floor effect for the negative affect domain of OSPRO-YF. Neither total score had a floor or ceiling effect.

Conclusions: STarTBack and OSPRO-YF are short screening tools with acceptable convergent and known-group construct validity and no floor or ceiling effect of their total score. Both tools could assist with the identification, evaluation, and management of psychological distress in patients presenting to tertiary care spine centres.

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三级脊柱护理中心的风险分层:STarTBack和OSPRO-YF筛查工具的比较。
目的:据报道,STarT背部筛查工具和OSPRO-YF量表是评估初级保健环境中持续疼痛或长期残疾风险的准确工具。我们使用在三级医疗脊柱中心就诊的常见患者样本,对这些工具的结构收敛性和已知群体有效性以及天花板-地板效应(CFE)进行了比较。方法:这是一项横断面研究,研究对象为有和没有与工作相关的背部损伤的患者。医院焦虑和抑郁量表(HADS)被用作收敛有效性的参考结果测量。对于已知的群体有效性,我们检查了量表区分不同补偿水平、非器质性体征的存在和工作状态的能力。计算CFE值。结果:包括50名连续受伤的工人,以及50名因腰痛而没有主动索赔的患者。STarTBack和OSPRO-YF与HADS的抑郁成分有中度至高度的相关性(分别为0.69至0.77),有利于OSPRO-YF的统计学显著差异。STarTBack的风险分层类别能够区分具有可补偿损伤、非器质性体征和其他症状的患者,和无法工作(p值从0.002到<0.001)。OSPRO-YF的身体活动和工作恐惧回避信念结构始终优于其他黄旗结构(p值在0.008到<0.001之间)。STarTBack的心理子得分显示出上限效应。OSPRO-YF的负面影响域存在下限效应。总分都没有下限或上限效应。结论:STarTBack和OSPRO-YF是一种短筛选工具,具有可接受的收敛性和已知的组构有效性,其总分没有下限或上限效应。这两种工具都有助于识别、评估和管理接受三级脊柱护理中心治疗的患者的心理困扰。
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来源期刊
Physiotherapy Canada
Physiotherapy Canada REHABILITATION-
CiteScore
1.90
自引率
20.00%
发文量
93
审稿时长
>12 weeks
期刊介绍: Physiotherapy Canada is the official, scholarly, refereed journal of the Canadian Physiotherapy Association (CPA), giving direction to excellence in clinical science and reasoning, knowledge translation, therapeutic skills and patient-centred care. Founded in 1923, Physiotherapy Canada meets the diverse needs of national and international readers and serves as a key repository of inquiries, evidence and advances in the practice of physiotherapy. Physiotherapy Canada publishes the results of qualitative and quantitative research including systematic reviews, meta analyses, meta syntheses, public/health policy research, clinical practice guidelines, and case reports. Key messages, clinical commentaries, brief reports and book reviews support knowledge translation to clinical practice. In addition to delivering authoritative, original scientific articles and reports of significant clinical studies, Physiotherapy Canada’s editorials and abstracts are presented in both English and French, expanding the journal’s reach nationally and internationally. Key messages form an integral part of each research article, providing a succinct summary for readers of all levels. This approach also allows readers to quickly get a feel for ‘what is already known’ and ‘what this study adds to’ the subject. Clinician’s commentaries for key articles assist in bridging research and practice by discussing the article’s impact at the clinical level. The journal also features special themed series which bring readers up to date research supporting evidence-informed practice. The Canadian Physiotherapy Association (CPA) is the national professional association representing almost 15,000 members distributed throughout all provinces and territories. CPA’s mission is to provide leadership and direction to the physiotherapy profession, foster excellence in practice, education and research, and promote high standards of health in Canada.
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