title: The predictive and external validity of the STarT Back Tool in Danish primary care.
abstract: OBJECTIVE
  The STarT Back Tool (SBT) was recently translated into Danish and its concurrent validity described. This study tested the predictive validity of the Danish SBT.
  
  
  METHODS
  Danish primary care patients (n = 344) were compared to a UK cohort. SBT subgroup validity for predicting high activity limitation at 3 months' follow-up was assessed using descriptive proportions, relative risks, AUC and odds ratios.
  
  
  RESULTS
  The SBT had a statistically similar predictive ability in Danish primary care as in UK primary care. Unadjusted relative risks for poor clinical outcome on activity limitation in the Danish cohort were 2.4 (1.7-3.4) for the medium-risk subgroup and 2.8 (1.8-3.8) for the high-risk subgroup versus 3.1 (2.5-3.9) and 4.5 (3.6-5.6) for the UK cohort. Adjusting for confounders appeared to explain the lower predictive ability of the Danish high-risk group.
  
  
  CONCLUSIONS
  The Danish SBT distinguished between low- and medium-risk subgroups with a similar predictive ability of the UK SBT. That distinction is useful information for informing patients about their expected prognosis and may help guiding clinicians' choice of treatment. However, cross-cultural differences in the SBT psychosocial subscale may reduce the predictive ability of the high-risk subgroup in Danish primary care.
authors: Research Department, Spine Centre of Southern Denmark, Hospital Lillebaelt, Institute of Regional Health Services Research, University of Southern Denmark, A Member of the Clinical Locomotion Network, Oestre Hougvej 55, Middelfart 5500, Denmark. lars.morsoe@slb.regionsyddanmark.dk
authors: Lars
authors: L
authors: Morsø
authors: Peter
authors: P
authors: Kent
authors: Hanne B
authors: HB
authors: Albert
authors: Jonathan C
authors: JC
authors: Hill
authors: Alice
authors: A
authors: Kongsted
authors: Claus
authors: C
authors: Manniche
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003431:Cross-Cultural Comparison; D003718:Denmark; D005260:Female; D006801:Humans; D007802:Language; D017116:Low Back Pain / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011320:Primary Health Care; D011584:Psychology; D014177:Translations; D014218:Triage / Q000379:methods*; D006113:United Kingdom
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