Distribution of prognostic subgroups, assessed by STarT Back Screening Tool, in Veterans with low back pain receiving on-site chiropractic care: a cross-sectional chart review

J Can Chiropr Assoc. 2026 Apr;70(1):68-80. Epub 2026 Apr 30.

ABSTRACT

OBJECTIVE: The primary aim of this study was to report the distribution of prognostic subgroups, as determined by The Keele (STarT) Back Screening Tool (SBT) in Veterans with low back pain presenting for consultation at a chiropractic clinic within the Veterans Health Administration (VHA).

METHODS: A chart review was conducted on all Veterans completing an initial consultation at a single VHA chiropractic clinic between April 15th, 2021 and January 31st, 2023. STarT Back Screening Tool scores and PROs were collected from the medical record corresponding to the date of consultation available in the VHA's electronic healthcare record (EHR) system. The proportion of each SBT subgroup (i.e., "low-risk", "medium-risk", and "high-risk") was calculated and subgroup differences across patient reported outcomes (PROs) were assessed.

RESULTS: Of 458 completed consultations, 386 (84.3%) sought care for low back pain and 251 (54.8%) had SBT data collected; 51 (20.3%) scored low-risk, 107 (42.6%) medium-risk, and 93 (37.1%) high-risk for persistent disability. As expected, the subgroups differed across baseline PRO.

CONCLUSIONS: In this chiropractic clinic, the percentage of Veterans with a favorable prognosis suggested by SBT was low.

PMID:42238485 | PMC:PMC13229144