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Table 4 Summary of included predictive screening instruments

From: Can screening instruments accurately determine poor outcome risk in adults with recent onset low back pain? A systematic review and meta-analysis

Instrument Summary of instrument Scoring method Cut-off scores/subgrouping
STarT Back Tool (SBT) [46] 9-item, self-report questionnaire; items screen for predictors of persistent disabling back pain and include radiating leg pain, pain elsewhere, disability (2 items), fear, anxiety, pessimistic patient expectations, low mood and how much the patient is bothered by their pain; all 9-items use a response format of ‘agree’ or ‘disagree’, with exception to the bothersomeness item, which uses a Likert scale. Two scores are produced – an overall score and a distress (psychosocial) subscale Total scores of 3 or less = low risk
If total score is 4 or more:
- Those with psychosocial subscale scores of 3 or less = medium risk
- Those with psychosocial subscale scores of 4 or more = high risk
Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ) [67] and Acute Low Back Pain Screening Questionnaire (ALBPSQ) [68] 25-item, self-report questionnaires; items screen for six factors: self-perceived function, pain experience, fear-avoidance beliefs, distress, return to work expectancy, and pain coping Total score calculated from 21 items and can range from 2 to 210 points; higher values indicate more psychosocial problems A cut-off of 105 proposed for indicating those ‘at risk’ of persisting problems
OMPSQ (Short form) [32] 10-item questionnaire covering five domains: self-perceived function, pain experience, fear-avoidance beliefs, distress, and return to work expectancy; demonstrated to have similar discriminative ability to original OMPSQ Scores range from 0 to 100 (higher scores indicate higher risk) A cut-off of 50 recommended to indicate those ‘at risk’ of persisting pain related disability
Vermont Disability Prediction Questionnaire (VDPQ) [49] 11-item self-report questionnaire; assesses perceptions of who was to blame for the injury, relationships with co-workers and employer, confidence that they will be working in 6 months, current work status, job demands, availability of job modifications, length of time employed, and job satisfaction Hand scored (maximum score of 23) No optimal cut-off recommended
Back Disability Risk Questionnaire (BDRQ) [40] 16-item self-report questionnaire; items include demographics, health ratings, workplace concerns, pain severity, mood, and expectations for recovery Sum score calculated No optimal cut-off recommended
Absenteeism screening questionnaire (ASQ) [51] 16-item, self-report questionnaire; assesses potential occupational back pain disability and risk factors including: work factors (3), physical health (2), supervisor response (1), pain (2), mood (2), wellness/job satisfaction (3), and expectations for recovery (1); mixture of nominal, ordinal and interval scale response options ‘Flag’ related items are summed and level of risk categorised as low, medium or high 0–1 flag items = low risk
2–3 items = medium risk
4–9 items = high risk
Chronic Pain Risk Score (CPRS) [61] Three graded chronic pain scale ratings of pain intensity, three ratings of activity interference, the number of activity limitation days, the number of days with pain in the past 6 months, depressive symptoms, the number of painful sites Maximum score of 28 (higher scores indicate greater risk) No optimal cut-off recommended
Hancock Clinical Prediction Rule (HCPR) [69] 3-item self-report questionnaire, items assess baseline pain (≤ 7/10), pain duration (≤ 5 days) and number of previous painful episodes (≤ 1) Status on the prediction rule determined by calculating the number of predictors of recovery present Risk classification based on the number of predictors of recovery present (0–3)