We would like to thank Hill and Hay for their commentary1 on our study.2 We believe the commentary highlights perhaps the most relevant question related to potential value of screening tools such as the STarT Back Screening Tool (SBT)—their ability to provide direction on the most appropriate management strategies for patients in different categories. Along with Hill and Hay, we believe that it is a critical research endeavor to develop tools to help clinicians to subgroup patients with low back pain (LBP) for the purpose of improving decision making. We seem to differ, however, in our interpretation of the results of this study with respect to the potential of the SBT to improve decision making in the treatment of patients with LBP. We welcome the opportunity to clarify our perspective and hopefully to advance the conversation on this important topic.
The SBT was developed as a screening tool to identify prognostic indicators from a general practice environment.3 An intriguing aspect of the SBT was that it explicitly set out to identify prognostic indicators that may be modifiable with treatment provided by physical therapists beyond the general practice environment. As such, the tool may prove extremely useful in helping general practitioners to identify the patients with LBP who stand to benefit the most from referral to physical therapy. The developers of the SBT validated …
