title: [Comparison of two screening questionnaires for patients with low back pain. Collation of risk factors for chronification].
abstract: BACKGROUND
  Screening for risk factors for chronic low back pain (LBP) (yellow flags) is recommended by clinical guidelines. Various questionnaires to assess yellow flags have been proposed.
  
  
  OBJECTIVE
  The aim of this study was to compare the prognostic validity of two screening questionnaires.
  
  
  METHODS
  This was a prospective observational study with 241 LBP patients from 9 general practitioners, 4 orthopedic surgeons and 2 pain clinics. We compared the Örebro musculoskeletal pain questionnaire (ÖMSPQ) and the Heidelberg short questionnaire (HKF-R10) which were completed by all patients at inclusion before the consultation. Primary outcomes were assessed after 3 months by mail. Clinical endpoints were pain intensity, disability and more than two follow-up consultations.
  
  
  RESULTS
  The sensitivity of the HKF-R10 to predict the primary outcome ranged from 81 % to 88 %, while the specificity was much lower (37-47 %). The ÖMSPQ showed an opposite pattern with a low sensitivity ranging from 50 % to 58 % but a higher specificity (77-80 %). In patients initially classified as having chronic LBP (n = 81), using the questionnaires as a diagnostic tool, the sensitivity of both questionnaires increased but specificity decreased. Single items may perform better with regard to primary outcome than the sum scores.
  
  
  CONCLUSIONS
  Both screening questionnaires for chronic LBP have insufficient diagnostic and prognostic validity for routine use in ambulatory care. Further studies are needed to improve diagnostic and prognostic validity and to elaborate criteria for a targeted use of screening questionnaires to guide therapeutic interventions.
authors: Abteilung SHIP-KEF, Institut für Community Medicine, Universitätsmedizin Greifswald, Walther-Rathenau-Str. 48, 17487, Greifswald, Deutschland, carsten.schmidt@uni-greifswald.de.
authors: C O
authors: CO
authors: Schmidt
authors: G
authors: G
authors: Lindena
authors: M
authors: M
authors: Pfingsten
authors: T
authors: T
authors: Kohlmann
authors: J-F
authors: JF
authors: Chenot
mesh_terms: D000063:Accidents, Traffic / Q000331:legislation & jurisprudence; D002908:Chronic Disease; D035881:Compensation and Redress / Q000331:legislation & jurisprudence; D003937:Diagnosis, Differential; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D005260:Female; D005858:Germany; D006801:Humans; D007346:Insurance, Accident / Q000331:legislation & jurisprudence; D008016:Life Change Events; D017116:Low Back Pain / Q000175:diagnosis* / Q000523:psychology*; D008403:Mass Screening / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014911:Whiplash Injuries / Q000175:diagnosis / Q000523:psychology; D055815:Young Adult