The Japanese version of the STarT Back Tool predicts 6-month clinical outcomes of low back pain

Abstract Background The STarT Back Tool classifies patients into low-, medium-, or high-risk groups according to risk for chronic low back pain. The Japanese version of the STarT Back Tool (STarT-J) has been translated and psychometrically validated. The present analysis investigated the predictive ability of the STarT-J. Methods Baseline data were collected through an online survey conducted with Japanese patients with low back pain. Long-term outcomes were assessed in a 6-month follow-up survey. Clinical outcomes at 6 months were evaluated with a pain numerical rating scale, the Roland–Morris Disability Questionnaire, and the EuroQol 5 Dimension. Differences in these scores among the three STarT-J risk groups were analyzed. Participants' perceived changes in low back pain and overall health status were examined to determine associations between the chronicity of low back pain at 6 months and STarT-J risk groups. Results Data of 1228 volunteers who responded to the baseline and follow-up surveys were included in this analysis. Mean ± standard deviation (SD) scores for the pain numerical rating scale and the Roland–Morris Disability Questionnaire were highest in the high-risk group (5.6 ± 1.9 and 9.6 ± 7.5) and lowest in the low-risk group (3.9 ± 1.6 and 2.1 ± 3.5). Mean ± SD EuroQol 5 Dimension index scores were lowest in the high-risk group (0.66 ± 0.20) and highest in the low-risk group (0.86 ± 0.14). A small percentage of high-risk patients (5.3%) perceived improvement in low back pain at the 6-month follow-up. Conclusions The STarT-J predicted 6-month pain and disability outcomes. The STarT-J is an easy-to-use tool to screen for patients who are more likely to have chronic low back pain, and may be useful to initiate stratified care in primary care settings.