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

Spine (Phila Pa 1976). 2014 Jan 15;39(2):E123-8. doi: 10.1097/BRS.0000000000000062.


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.

Publication types

  • Observational Study
  • Validation Study

MeSH terms

  • Adult
  • Cross-Cultural Comparison*
  • Female
  • Humans
  • Low Back Pain / diagnosis*
  • Low Back Pain / ethnology*
  • Male
  • Middle Aged
  • Multilingualism*
  • Pain Measurement / methods
  • Pain Measurement / standards*
  • Prospective Studies
  • Surveys and Questionnaires / standards*