Does the STarT Back screening tool correlate with the focus on therapeutic outcomes functional scale in patients with low back pain

Study Design: Cross-sectional correlational. Objectives: Examine the relationship between the STarT Back Screening Tool (SBST) and the Focus on Therapeutic Outcomes (FOTO) functional status questionnaire in patients with low back pain (LBP). Background: LBP is one of the most common and costly orthopedic conditions in the health-care system, but the diagnosis, prognosis, and treatment are unclear and uncertain. Tools such as the SBST and FOTO have been developed as a way to subclassify individuals with LBP to determine prognosis and stratify care. Methods: The SBST and FOTO questionnaires were administered during the initial consultation with a physical therapist for a chief complaint of LBP. Kendall's tau-c coefficient was calculated for correlation between the SBST risk stratification and FOTO functional staging. Kappa coefficient was calculated for correlation between the dichotomized SBST psychosocial subscale and the dichotomous fear avoidance level derived from the FOTO questionnaire. Results: A total of 65 patients were included in the final analysis ranging in age from 18 to 89 years. The correlation between SBST risk level and FOTO functional staging was poor (Kendall's tau-c = 0.406, P K = 0.099, P = 0.335). Conclusion: The poor inverse relationship between the SBST and FOTO demonstrates that both tools should be used concurrently to complement each other to effectively subclassify patients with LBP. Future efforts may want to focus on integrating constructs from the SBST into the FOTO computerized adaptive test to improve risk stratification. The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement.