The Keele STarT Back Screening Tool
The Subgroups for Targeted Treatment (STarT) Back Screening Tool was developed and validated to provide insight into back pain prognostic indicators relevant to initial decision making in primary care. 

Using stratified management according to patient's prognosis (low, medium, or high risk) using the STarT tool showed to be a cost-effective approach. 
Research authors: Jonathan C. Hill, Kate M. Dunn, Martyn Lewis, Ricky Mullis, Chris J. Main, Nadine E. Foster, Elaine M. Hay
Details Formula Study characteristics Files & References
Model author
Model ID
Revision date
MeSH terms
  • Low Back Pain
  • Back Pain
  • Psychosocial Factors
  • Physical Therapy Specialty
  • Model type
    Custom model (Calculation)

    Additional information

    Of 244 patients identified, 131 (54%) returned the questionnaire and 107 (82%) agreed to further contact. Baseline development sample characteristics are shown. 74 test–retest questionnaires were posted, of which 53 (72%) were returned; 23 patients reported that their symptoms remained stable within the 2-week period.

    Study Population

    Total population size: 131
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    Females: {{ model.numberOfFemales }}

    Continuous characteristics

    Name Mean SD Unit
    Age 44 10 years
    Screening tool score (overall) 4.33 2.6 points
    Screening tool score (psychosocial subscale) 2.17 1.6 points
    Roland-Morris Disability Questionnaire 8.6 6.6 points
    Tampa Scale of Kinesiophobia 40.9 7.5 points
    Pain Catastrophizing Scale 18.9 12.4 points

    Categorical characteristics

    Name Subset / Group Nr. of patients
    Currently employed No 36
    Yes 95
    Reason for unemployment (n=35) Not working due to back 17
    Looking after home 7
    Retired 0
    Student 2
    Not working other 9
    Days off work in past 6/12 No time off work 31
    <7 days 23
    1-4 weeks 18
    1-3 months 15
    >3 months 6
    Episode duration Less than 1 month 32
    1 to 3 months 19
    4 to 6 months 15
    7 months to 3 years 29
    More than 3 years 34
    Pain intensity Mild (0-5) 85
    Moderate (6-7) 29
    Severe (8-10) 17
    Referred leg pain No 56
    Yes 75
    Comorbid pain in neck/shoulder No 68
    Yes 63
    Very or extremely bothered by back No 75
    Yes 56
    The Keele STarT Back Screening Tool
    Refer to Intended Use for instructions before use
    Evidencio B.V., Irenesingel 19, 7481 GJ, Haaksbergen, the Netherlands

    The total score on the STarT tool is:

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    Notes are only visible in the result download and will not be saved by Evidencio

    The total score on the STarT tool is: Points

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    Outcome stratification

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    Conditional information

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    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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