Validation of the STarT Back Screening Tool in Primary Care Management of Back Pain in the Military Health System: A Randomized Trial of Riskstratified Care
Technical Report,15 Sep 2018,14 Sep 2019
The Geneva Foundation Tacoma United States
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The management of LBP imposes significant economic burden on individuals, health care delivery systems and society. Total annual direct healthcare costs in the United States incurred by patients with LBP were estimated at 90 billion dollars in 1998, 60 higher than costs for individuals without LBP. Increasing amounts of research point to the importance of even the earliest care decisions made about the management of patients with LBP towards predicting the outcomes of care including work readiness, and the likelihood of utilization of high cost procedures. A novel approach is to determine whether stratified care according to the estimated risk of poor prognosis improves clinical outcomes. The STarT Back Screening Tool SBST does precisely this, classifying patients into one of three risk categories low, medium, and highfor targeted treatment based on the presence of modifiable physical and psychological indicators of persistent, disabling symptoms. Recent studies have shown improved outcomes and significant costs saving associated with using the tool in primary care settings. However, it is unknown whether a similar stratified care approach will achieve similar results in the primary care management of patients with low back pain in the Military health System. The purpose of this study is to validate the clinical and cost effectiveness of the STarT Back Screening Tool in the primary care management of patients with LBP in the MHS. The overall hypothesis is that, for patients seeking care for low back pain, treatment decisions based on risk stratification will result in significantly better long term outcomes and decreased overall healthcare utilization compared to the usual care method of making treatment decisions.
- Medicine and Medical Research