Validity and reliability of the French version of the STarT Back screening tool for patients with low back pain.

STUDY DESIGN: Observational prospective study. OBJECTIVE: Our objective was to assess the reliability and validity of the French version of the Keele STarT Back Screening Tool (SBST). SUMMARY OF BACKGROUND DATA: The SBST is a recently validated tool developed to identify subgroups of patients with low back pain (LBP) to guide early secondary prevention in primary care. METHODS: Outpatients 18 years or older with LBP, attending a rehabilitation center, a back school, a private physiotherapy unit, or a fitness center were included. Patients were assessed through the SBST, Roland-Morris Disability Questionnaire, Örebro Musculoskeletal Pain Screening Questionnaire, Medical Outcomes Survey Short Form-36 questionnaire, and a pain visual analogue scale. Test-retest reliability was assessed with Kappa score or the intraclass correlation coefficient, internal consistency of the Psychological subscale with the Cronbach α coefficient, construct validity with the Spearman correlation coefficient, and floor and ceiling effects by percentage frequency of lowest or highest possible score achieved by respondents. RESULTS: One hundred eight patients with LBP were included. The test-retest reliability of the SBST total score was excellent with an intraclass correlation coefficient of 0.90 (0.81-0.95). The Cronbach α coefficient was 0.73 showing a good internal consistency for the Psychological subscale. High Spearman correlation coefficients of 0.74 between SBST and Roland-Morris Disability Questionnaire, and 0.74 between the SBST and Örebro Musculoskeletal Pain Screening Questionnaire were observed. As expected, low-to-moderate correlations were observed between the SBST total score and some dissimilar measures of the Short-Form 36. The lowest possible SBST score was observed for 8 patients (7.4%), whereas only 3 patients (2.8%) had the highest possible SBST score. CONCLUSION: The French version of the SBST is a reliable and valid questionnaire consistent with the original English version. Therefore, this new version may help French-speaking clinicians and scientists to stratify patients with LBP. LEVEL OF EVIDENCE: 2.

Translation validation of a new back pain screening questionnaire (the STarT Back Screening Tool) in French.

BACKGROUND: Low back pain (LBP) is a major public health problem and the identification of individuals at risk of persistent LBP poses substantial challenges to clinical management. The STarT Back questionnaire is a validated nine-item patient self-report questionnaire that classifies patients with LBP at low, medium or high-risk of poor prognosis for persistent non-specific LBP. The objective of this study was to translate and cross-culturally adapt the English version of the STarT Back questionnaire into French. METHODS: The translation was performed using best practice translation guidelines. The following phases were performed: contact with the STarT Back questionnaire developers, initial translations (English into French), synthesis, back translations, expert committee review, test of the pre-final version on 44 individuals with LBP, final version. RESULTS: The linguistic translation required minor semantic alterations. The participants interviewed indicated that all items of the questionnaire were globally clear and comprehensible. However, 6 subjects (14%) wondered if two questions were related to back pain or general health. After discussion within the expert committee and with the developer of the STarT Back tool, it was decided to modify the questionnaire and to add a reference to back pain in these two questions. CONCLUSIONS: The French version of the STarT Back questionnaire has been shown to be comprehensible and adapted to the French speaking general population. Investigations are now required to test the psychometric properties (reliability, internal and external validity, responsiveness) of this translated version of the questionnaire.