Does the Keele STarT Back Screening Tool Contribute to Effectiveness in Treatment and Cost and Loss of Follow-Up of the Mechanical Diagnosis and Therapy for Patients with Low Back Pain?

BACKGROUND: Mechanical diagnosis and therapy (MDT) and the stratified approach using the Keele STarT Back Screening Tool (SBST) are examples of stratified low back pain (LBP) management. We investigated whether the medium-high risk in SBST can contribute to the time and sessions until discharge from MDT (Question 1) and to the loss of follow-up before identifying a promising management strategy (Question 2). METHODS: A retrospective chart study was conducted. Multiple regression modeling was constructed using 10 independent variables, including whether the SBST was medium-high risk or not for Question 1, and the 9/10 independent variables for Question 2. RESULTS: The data of 89 participants for Question 1 and 166 participants for Question 2 were analyzed. SBST was not a primary contributing factor for Question 1 (R(2) = 0.17-0.19). The model for Question 2 included SBST as a primary contributing factor and the shortest distance from the patient address to the hospital as a secondary contributing factor (93.4% correct classification). CONCLUSION: SBST status was not a primary contributing factor for time and sessions until discharge from MDT, but was a critical factor for the loss of MDT follow-up before identifying a promising management strategy.