STarT Back Tool
The STarT Back trial which was recently published in The Lancet was designed to compare the clinical and cost effectiveness of stratified management approach; allocating patients to different treatment pathways based on their prognosis (low, medium, or high risk of poor outcome); with that of current best practice. The trial was was funded by Arthritis Research UK and demonstrates that this new model results in greater health benefits, achieved at a lower average health-care cost, with an average saving to health services of £34.39 per patient and societal savings of £675 per patient.
The tool helps primary care clinicians (GPs, physiotherapists etc) to group patients into 3 categories of risk of poor outcome (persistent disabling symptoms) – low, medium, and high-risk. By being able to categorise patients into these 3 groups, clinicians are then able to target interventions to each sub-group of patients to help improve outcome. A randomised control trial of this hypothesis has just been completed, the results of which are due for publication.