title: The concurrent validity of brief screening questions for anxiety, depression, social isolation, catastrophization, and fear of movement in people with low back pain.
abstract: OBJECTIVE
  The aim of this study was to (1) test the concurrent validity of brief screening questions for 5 psychosocial constructs (anxiety, depression, social isolation, catastrophization, and fear of movement) and (2) translate into Danish and validate those screening questions.
  
  
  METHODS
  Data were collected from 5 cross-sectional samples (total n=1105) of people seeking care for low back pain in Australian primary care settings and a Danish secondary care hospital. The responses to English and Danish-translated versions of 1-item or 2-item screening questions were compared with those of validated full-length questionnaires.
  
  
  RESULTS
  Compared with anxiety, depression, and social isolation scores from full-length questionnaires, screening questionnaire responses demonstrated: a correlation of 0.62 to 0.83, overall accuracy of 78% to 91%, sensitivity of 70% to 82%, specificity of 75% to 95%, positive likelihood ratios of 3.3 to 13.9, and negative likelihood ratios of 0.21 to 0.33. For catastrophization and fear of movement, the results demonstrated: correlation of 0.89 to 0.95, overall accuracy of 88% to 93%, sensitivity of 78% to 88%, specificity of 91% to 96%, positive likelihood ratios of 9.5 to 20.8, and negative likelihood ratios of 0.13 to 0.23.
  
  
  CONCLUSIONS
  The concurrent validity of these screening questions was comparable to, or better than, alternate questions previously reported, and stable across age, sex, pain intensity, pain duration, and counties. On the basis of the observed likelihood ratios, all of the screening questions provided moderate or strong evidence to rule in or out an extreme score on each psychosocial construct. Given the ease of administration of these brief screening questions, their prognostic and treatment implications should be investigated.
authors.affiliation: *Research Department, The Spine Centre of Southern Denmark, Lillibaelt Hospital, Institute of Regional Health Services Research, University of Southern Denmark, Middelfart, Denmark †Physiotherapy Department, Eastern Health-Maroondah Hospital §Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine ‡Department of Physiotherapy, Monash University, Melbourne, Vic., Australia ∥Monash Department of Clinical Epidemiology, Cabrini Hospital, Malvern, Vic., Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Kent
authors.forename: Saeida
authors.initials: S
authors.lastname: Mirkhil
authors.forename: Jenny
authors.initials: J
authors.lastname: Keating
authors.forename: Rachelle
authors.initials: R
authors.lastname: Buchbinder
authors.forename: Claus
authors.initials: C
authors.lastname: Manniche
authors.forename: Hanne Birgit
authors.initials: HB
authors.lastname: Albert
mesh_terms: D000328:Adult; D001007:Anxiety; D001315:Australia; D058443:Catastrophization; D003718:Denmark; D003863:Depression; D005239:Fear; D005260:Female; D006801:Humans; D007802:Language; D016013:Likelihood Functions; D017116:Low Back Pain / Q000175:diagnosis* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009068:Movement; D011320:Primary Health Care; D063728:Secondary Care Centers; D012680:Sensitivity and Specificity; D012934:Social Isolation; D011795:Surveys and Questionnaires