European Spine Journal

, Volume 20, Issue 12, pp 2166–2173

Translation and discriminative validation of the STarT Back Screening Tool into Danish

  • Lars Morsø
  • Hanne Albert
  • Peter Kent
  • Claus Manniche
  • Jonathan Hill
Original Article

Abstract

Objective

The STarT Back Screening Tool (STarT) is a nine-item patient self-report questionnaire that classifies low back pain patients into low, medium or high risk of poor prognosis. When assessed by GPs, these subgroups can be used to triage patients into different evidence-based treatment pathways. The objective of this study was to translate the English version of STarT into Danish (STarT-dk) and test its discriminative validity.

Methods

Translation was performed using methods recommended by best practice translation guidelines. Psychometric validation of the discriminative ability was performed using the Area Under the Curve statistic. The Area Under the Curve was calculated for seven of the nine items where reference standards were available and compared with the original English version.

Results

The linguistic translation required minor semantic and layout alterations. The response options were changed from “agree/disagree” to “yes/no” for four items. No patients reported item ambiguity using the final version. The Area Under the Curve ranged from 0.735 to 0.855 (CI95% 0.678–0.897) in a Danish cohort (n = 311) and 0.840 to 0.925 (CI95% 0.772–0.948) in the original English cohort (n = 500). On four items, the Area Under the Curve was statistically similar between the two cohorts but lower on three psychosocial sub-score items.

Conclusions

The translation was linguistically accurate and the discriminative validity broadly similar, with some differences probably due to differences in severity between the cohorts and the Danish reference standard questionnaires not having been validated. Despite those differences, we believe the results show that the STarT-dk has sufficient patient acceptability and discriminative validity to be used in Denmark.

Keywords

STarT Back Screening Tool Linguistic Cultural Translation Psychometric Validation 

Supplementary material

586_2011_1911_MOESM1_ESM.doc (42 kb)
Supplementary material 1 (DOC 42 kb)

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Lars Morsø
    • 1
    • 2
  • Hanne Albert
    • 1
    • 2
  • Peter Kent
    • 1
    • 2
  • Claus Manniche
    • 1
    • 2
  • Jonathan Hill
    • 3
  1. 1.Research Department, Spine Centre of Southern DenmarkHospital LillebaeltMiddelfartDenmark
  2. 2.Institute of Regional Health Services ResearchUniversity of Southern DenmarkMiddelfartDenmark
  3. 3.Primary Care Musculoskeletal Research CentreKeele UniversityStaffordshireUK

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