Publicado

2023-01-01

Internal consistency and criterion, convergent, and discriminant validity of the Start Back Screening Tool in a Colombian sample

Consistencia interna y validez convergente, discriminante y de criterio del Start Back Screening Tool en una muestra colombiana

Palabras clave:

Validity of results, Low Back Pain, Primary HealthCare, Diagnosis (en)
Validez de la prueba, Dolor de la región lumbar, Atención primaria de salud, Diagnóstico (es)

Autores/as

Introduction: Low back pain (LBP) is a frequent reason for consultation, and one of the main causes of permanent work disability. Stratifying the risk of disability due to LBP allows the development of specific therapeutic interventions; however, such stratification requires valid and reliable instruments.

Objective: To determine the internal consistency, as well as the convergent, discriminant, and criterion validity of the Start Back Screening Tool (SBST) questionnaire in a Colombian sample.

Materials and methods: Quantitative scale validation study conducted in 68 adult patients with LBP who underwent a physical therapy intervention (10 sessions) between 2019 and 2020 in a clinic located in Chía, Colombia. Participants completed the SBST, the Numerical Pain Rating Scale (NPRS), and the Roland-Morris Disability Questionnaire (RMDQ) at three times: pre-intervention, post-intervention, and after 6 weeks of follow-up (without treatment). The internal consistency of the SBST was determined using Cronbach's alpha, omega, lambda-6, and greatest lower bound (GLB) coefficients. Regarding criterion and construct validity, correlations between the SBST and the NPRS and the RMDQ were assessed using the Pearson’s correlation coefficient. Finally, a repeated measures ANOVA was performed between the SBST mean scores obtained at the three moments in order to estimate its discriminant validity.

Results: The internal consistency of the instrument, according to the different coefficients, ranged from acceptable to high (alpha=0.634; omega=0.648; lambda-6=0.664; GLB=0.780). Positive correlations were found between the SBST mean score (mean=3.824; SD=1.892) and the NPRS (r=0.257; p=0.035) and RMDQ (r=0.475; p<0.0010) mean scores, as well as significant differences between pre-intervention, post-intervention, and follow-up SBST mean scores (ANOVA: F=33.722; p<0.001).

Conclusion: SBST is a valid and reliable instrument to classify the level of risk of poor prognosis in Colombian patients with LBP.

Introducción. El dolor lumbar (DL) es una causa frecuente de consulta y una de las principales causas de incapacidad laboral permanente. La estratificación del riesgo de discapacidad por DL permite desarrollar intervenciones terapéuticas específicas; sin embargo, dicha estratificación requiere instrumentos válidos y confiables.

Objetivo. Determinar la consistencia interna y la validez convergente, discriminante y de criterio del cuestionario Start Back Screening Tool (SBST) en una muestra colombiana.

Materiales y métodos. Estudio cuantitativo de validación de pruebas realizado en 68 pacientes adultos con DL que recibieron una intervención fisioterapéutica (10 sesiones) entre 2019 y 2020 en una clínica de Chía, Colombia. Los participantes diligenciaron el SBST, la escala numérica de clasificación del dolor (ENCD) y el cuestionario Roland Morris Disability (RMD) en tres momentos: pre-intervención, post-intervención y luego de 6 semanas de seguimiento (sin tratamiento). La consistencia interna del SBST se determinó mediante los coeficientes alfa de Cronbach, Omega, lambda-6 y greatest lower bound (GLB). En cuanto a la validez de criterio y de constructo, se evaluaron las correlaciones entre el instrumento y la ENCD y el RMD mediante el coeficiente de correlación de Pearson. Finalmente, se realizó un ANOVA de medidas repetidas entre las medias de puntaje del SBST obtenidas en los tres momentos para estimar su validez discriminante.

Resultados. La consistencia interna del instrumento, según los diferentes coeficientes, varió entre aceptable y alta (alfa=0.634; omega=0.648; lambda-6=0.664; GLB=0.780). Se observaron correlaciones positivas entre el puntaje promedio en el SBST y los puntajes promedio en la ENCD (r=0.257; p=0.035) y la RMD (r=0.475; p<0.0010), así como diferencias significativas entre los puntajes promedio del SBST pre-intervención, post-intervención y seguimiento (ANOVA: F=33.722; p<0.001).

Conclusión. El SBST es un instrumento válido y confiable para clasificar el nivel de riesgo de mal pronóstico en pacientes colombianos con DL.

Descargas

Los datos de descargas todavía no están disponibles.

Citas

Fatoye F, Gebrye T, Odeyemi I. Real-world incidence and prevalence of low back pain using routinely collected data. Rheumatol Int. 2019;39(4):619-26. https://doi.org/d2gq.

Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-67. https://doi.org/gdnd74.

Bello-Villanueva AM, Benítez-Lara M, Oviedo-Trespalacios O. Características del dolor, aspectos psicológicos, calidad de vida y estrategias de afrontamiento en pacientes con dolor de espalda crónico en una ciudad de Colombia. Rev Colomb Anestesiol. 2017;45(4):310-6. https://doi.org/jxrk.

Kaplan W, Wirtz VJ, Mantel-Teeuwisse A, Stolk P, Duthey B, Laing R. Priority medicines for Europe and the world 2013 update. Geneva: World Health Organization; 2013 [cited 2023 Feb 23]. Available from: https://bit.ly/3Z0npUu.

Duque-Vera IL, Zuluaga-González DM, Pinilla-Burgos AC. Prevalencia de lumbalgia y factores de riesgo en enfermeros y auxiliares de la ciudad de Manizales. Hacia Prom. Salud. 2011;16(1):27-38.

Londoño J, Peláez-Ballestas I, Cuervo F, Angarita I, Giraldo R, Rueda JC, et al. Prevalencia de la enfermedad reumática en Colombia, según estrategia COPCORD-Asociación Colombiana de Reumatología. Estudio de prevalencia de enfermedad reumática en población colombiana mayor de 18 años. Rev Colomb Reumatol. 2018,25(4):245-56. https://doi.org/grhs4j.

Tolosa-Guzmán I, Romero ZC, Mora MP. Predicción clínica del dolor lumbar inespecífico ocupacional.Rev Cienc Salud. 2012;10(3):347-68.

Yilmaz-Yelvar GD, Dalkilinç M, Çirak Y, Parlak-Demir Y, Karadüz BN, Kolsuz MM. Validity and reliability of Turkish version of STarT Back Screening Tool. Agri. 2019;31(4):163-71. https://doi.org/gjk65x.

Hill JC, Dunn KM, Lewis M, Mullis R, Main CJ, Foster NE, et al. A primary care back pain screening tool: Identifying patient subgroups for initial treatment. Arthritis Rheum. 2008;59(5):632-41. https://doi.org/fdgbgr.

Schmidt PA, Naidoo V. Cross-cultural adaptation and validation of the start back screening tool in isizulu. S Afr J Physiother. 2020;76(1):1402. https://doi.org/jxrm.

Storm L, Rousing R, Andersen MO, Carreon LY. Usefulness of the STarT Back Screening Tool to predict pain problems after lumbar spine surgery. Dan Med J. 2018;65(12):A5517.

Haglund E, Bremander A, Bergman S. The StarT back screening tool and a pain mannequin improve triage in individuals with low back pain at risk of a worse prognosis - A population based cohort study. BMC Musculoskelet Disord. 2019;20(1):460. https://doi.org/gh8fsk.

Pilz B, Vasconcelos RA, Marcondes FB, Lodovichi SS, Mello W, Grossi DB. The Brazilian version of start back screening tool - translation, cross-cultural adaptation and reliability. Braz J Phys Ther. 2014;18(5):453-61. https://doi.org/gb9svk.

Gusi N, del Pozo-Cruz B, Olivares PR, Hernández-Mocholi M, Hill JC. The Spanish version of the ‘sTarT back screening tool’ (SBST) in different subgroups. Aten Primaria. 2011;43(7):356-61. https://doi.org/bmbw8d.

Alfonso Mora ML. El Método Meziéres para el “uso de sí” en personas con dolor lumbar. Estudio Mixto [doctoral thesis]. Barcelona: Universidad Ramon Llull; 2021.

Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, et al. Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: A systematic literature review. J Pain Symptom Manag. 2011;41(6):1073-93. https://doi.org/dqdtm8.

Kovacs FM, Llobera J, Gil del Real MT, Abraira V, Gestoso M, Fernández C, et al. Validation of the Spanish version of the Roland-Morris Questionnaire. Spine (Phila Pa 1976). 2002;27(5):538-42. https://doi.org/fq62j2.

Barbero-García MI, Garcia-Cueto E, Holgado-Tello FP, Vila-Abad E. Psicometría. Problemas resueltos. Madrid: Sanz y Torres S.L.; 2015.

Fritz JM, Beneciuk JM, George SZ. Relationship between categorization with the STarT Back Screening Tool and prognosis for people receiving physical therapy for low back pain. Phys Ther. 2011;91(5):722-32. https://doi.org/dnxw9v.

World Medical Association (WMA). WMA Declaration of Helsinki – Ethical principles for medical research involving human subjects. Fortaleza: 64th WMA General Assembly; 2013.

Colombia. Ministerio de Salud. Resolución 8430 de 1993 (octubre 4): Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. Bogotá D.C.; octubre 4 de 1993.

Mbada CE, Adeulure TG, Idowu OA, Oyewole OO, Odole AC, Afolabi TO, et al. Translation and psychometric evaluation of the Yoruba version of the STarT Back tool among persons with long-term non-specific low-back pain. Ann Ig. 2021;33(5):443-55. https://doi.org/jxrp.

Wiangkham T, Phungwattanakul N, Thongbai N, Situy N, Polchaika T, Kongmee I, et al. Translation, cross-cultural adaptation and psychometric validation of the Thai version of the STarT Back Screening Tool in patients with non-specific low back pain. BMC Musculoskelet Disord. 2021;22(1):454. https://doi.org/jxrq.

Billis E, Fousekis K, Tsekoura M, Lampropoulou S, Matzaroglou C, Gliatis J, et al. Cross-cultural validation of the start back screening tool in a Greek low back pain sample. Musculoskelet Sci Pract. 2021;53: 102352. https://doi.org/jxrr.

Giusti EM, Varallo G, Abenavoli A, Manzoni GM, Aletti L, Capodaglio P, et al. Factor Structure, Validity, and Reliability of the STarT Back Screening Tool in Italian Obese and Non-obese Patients With Low Back Pain. Front Psychol. 2021;12:740851. https://doi.org/jxrs.

Beneciuk JM, Bishop MD, Fritz JM, Robinson ME, Asal NR, Nisenzon AN, et al. The STarT back screening tool and individual psychological measures: evaluation of prognostic capabilities for low back pain clinical outcomes in outpatient physical therapy settings. Phys Ther. 2013;93(3):321-33. https://doi.org/f4p5qp.