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Validity and Reliability of the French Version of the STarT Back Screening Tool for Patients With Low Back Pain

Bruyère, Olivier PhD*,†,‡; Demoulin, Maryline MPH*; Beaudart, Charlotte MPH*,‡; Hill, Jonathan C. MD§; Maquet, Didier PhD; Genevay, Stéphane PhD; Mahieu, Geneviève MD; Reginster, Jean-Yves MD*,‡; Crielaard, Jean-Michel MD; Demoulin, Christophe PhD

doi: 10.1097/BRS.0000000000000062
Health Services Research

Study Design. Observational prospective study.

Objective. Our objective was to assess the reliability and validity of the French version of the Keele STarT Back Screening Tool (SBST).

Summary of Background Data. The SBST is a recently validated tool developed to identify subgroups of patients with low back pain (LBP) to guide early secondary prevention in primary care.

Methods. Outpatients 18 years or older with LBP, attending a rehabilitation center, a back school, a private physiotherapy unit, or a fitness center were included. Patients were assessed through the SBST, Roland-Morris Disability Questionnaire, Örebro Musculoskeletal Pain Screening Questionnaire, Medical Outcomes Survey Short Form-36 questionnaire, and a pain visual analogue scale. Test-retest reliability was assessed with Kappa score or the intraclass correlation coefficient, internal consistency of the Psychological subscale with the Cronbach α coefficient, construct validity with the Spearman correlation coefficient, and floor and ceiling effects by percentage frequency of lowest or highest possible score achieved by respondents.

Results. One hundred eight patients with LBP were included. The test-retest reliability of the SBST total score was excellent with an intraclass correlation coefficient of 0.90 (0.81–0.95). The Cronbach α coefficient was 0.73 showing a good internal consistency for the Psychological subscale. High Spearman correlation coefficients of 0.74 between SBST and Roland-Morris Disability Questionnaire, and 0.74 between the SBST and Örebro Musculoskeletal Pain Screening Questionnaire were observed. As expected, low-to-moderate correlations were observed between the SBST total score and some dissimilar measures of the Short-Form 36. The lowest possible SBST score was observed for 8 patients (7.4%), whereas only 3 patients (2.8%) had the highest possible SBST score.

Conclusion. The French version of the SBST is a reliable and valid questionnaire consistent with the original English version. Therefore, this new version may help French-speaking clinicians and scientists to stratify patients with LBP.

Level of Evidence: 2

The Keele STarT Back Screening Tool (SBST) is a tool for patients with low back pain. In this study, we show that the French version of the SBST is a reliable and valid questionnaire consistent with the original English version. Therefore, this version may be used by French-speaking clinicians and scientists.

Departments of *Public Health, Epidemiology and Health Economics and

Sport and Rehabilitation Sciences, University of Liège, Belgium

Réseau d'Epidémiologie Clinique International Francophone (RECIF), Lyon, France

§Arthritis Research UK Primary Care Centre, Keele University, Stoke-on-Trent, United Kingdom

Rheumatology Department, Geneva University Hospital, Switzerland; and

Physical Rehabilitation, Back Unit, CHU UCL Mont-Godinne-Dinant, Belgium.

Address correspondence and reprint requests to Olivier Bruyère, PhD, Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart-Tilman, Bât B23, 4000 Liège, Belgium; E-mail:

Acknowledgment date: April 23, 2013. First revision date: July 25, 2013. Acceptance date: September 25, 2013.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

Relevant financial activities outside the submitted work: consultancy, grants/grants pending and payment for lectures.

© 2014 by Lippincott Williams & Wilkins