title: Transcultural adaption and psychometric properties of the STarT Back Screening Tool among Finnish low back pain patients.
abstract: OBJECTIVE
  The STarT Back Screening Tool (SBST) is a 9-item questionnaire designed for screening low back pain (LBP) patients into three prognostic groups for stratified care. The stratified care approach has proven to be clinically more beneficial and cost-effective than the current best physiotherapy practice. The objective of this study was to translate, culturally adapt and study psychometric properties of the SBST among Finnish LBP patients.
  
  
  METHODS
  The SBST was translated into Finnish using appropriate translation guidelines. A total of 116 patients were recruited from outpatient clinics. They were asked to fill out two questionnaires within 1-7 days. The first questionnaire set included the SBST, Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) and intensities of back and leg pain (10-cm Visual Analogue Scale). The second questionnaire form included the SBST and a question about persistence of symptoms.
  
  
  RESULTS
  Some linguistic and cultural differences emerged during the translation process with item 1 ("spread down my legs"), item 2 ("neck and shoulder pain"), item 6 ("worrying thoughts") and item 9 ("bothersome"). The test-retest reliability of the SBST total score was excellent (intraclass correlation coefficient 0.78) and of the psychosocial subscale good (0.68). Cronbach's alpha for the psychosocial subscale was 0.55. Spearman's correlation coefficient between SBST total score and BDI was 0.38, ODI 0.39, ÖMPSQ 0.45, intensity of leg pain 0.45 and LBP 0.31. Based on analysis of variance, the SBST discriminated low- and medium-risk groups better than medium- and high-risk groups.
  
  
  CONCLUSIONS
  The Finnish translation of the SBST is linguistically accurate and has been adapted to the Finnish-speaking population. It showed to be a valid and reliable instrument and comparable with the original English version. Therefore, it may be used in clinical work with Finnish LBP patients.
authors: Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
authors: Susanna
authors: S
authors: Piironen
authors: Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
authors: Markus
authors: M
authors: Paananen
authors: Department of Psychiatry, Oulu University Hospital, Oulu, Finland.|Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
authors: Marianne
authors: M
authors: Haapea
authors: Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland.
authors: Markku
authors: M
authors: Hupli
authors: Department of Physical and Rehabilitation Medicine, Lapland Central Hospital, Rovaniemi, Finland.
authors: Paavo
authors: P
authors: Zitting
authors: Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.|Rokua Rehabilitation Ltd and Attendo Occupational Health Oulu, Oulu, Finland.
authors: Katja
authors: K
authors: Ryynänen
authors: Finnish Institute of Occupational Health, Health and Work Ability, and Disability Prevention Centre, Oulu and Helsinki, Finland.
authors: Esa-Pekka
authors: EP
authors: Takala
authors: Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
authors: Katariina
authors: K
authors: Korniloff
authors: Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK.
authors: Jonathan C
authors: JC
authors: Hill
authors: Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.|Department of Physical Medicine and Rehabilitation and Medicine, Jyväskylä Central Hospital, Jyväskylä, Finland.
authors: Arja
authors: A
authors: Häkkinen
authors: Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. jaro.karppinen@ttl.fi.|Finnish Institute of Occupational Health, Health and Work Ability, and Disability Prevention Centre, Oulu and Helsinki, Finland. jaro.karppinen@ttl.fi.|Center for Life Course Epidemiology, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland. jaro.karppinen@ttl.fi.
authors: Jaro
authors: J
authors: Karppinen
mesh_terms: D000328:Adult; D000368:Aged; D000066491:Clinical Decision-Making; D065246:Culturally Competent Care; D004185:Disability Evaluation; D005260:Female; D005387:Finland; D006305:Health Status Indicators; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011379:Prognosis; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014177:Translations
keywords: Low back pain; STarT Back Screening Tool; Translation; Validation