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Table 3 Identification of patients for ‘fast-track’ referrals to spinal specialist services. Three scenarios investigated

From: Subgrouping patients with sciatica in primary care for matched care pathways: development of a subgrouping algorithm

 

Sensitivity (95% CIa)

Specificity (95% CI)

Positive predictive value (95% CI)

Negative predictive value (95% CI)

% of total sample referred

Use of only clinical characteristics (total of 4b):

- Patients with 3 out of 4 clinical characteristics

68% (55–80)

60% (55–65)

21% (15–27)

93% (88–96)

43% (186/429)

- Patients with all 4 clinical characteristics

32% (20–45)

89% (85–92)

30% (19–44)

89% (86–92)

14% (59/429)

Use of clinical characteristics combined with STarT Back prognostic risk score (medium, high)c

- patients at ‘high’ risk on STarT Back, with 3 or more clinical characteristics

51% (37–64)

73% (68–78)

22% (16–31)

91% (87–94)

30% (129/429)

OR

- patients at ‘medium’ risk on STarT Back, with all 4 clinical characteristics

     
  1. aCI; Confidence Intervals
  2. bCurrent leg pain > 6 (NRS 0–10), pain below knee, interference with ability to do work/home activities > 6 (NRS 0–10) or ‘yes’ response on the RMDQ item, sensory deficit in painful leg with pin/prick testing
  3. cPatients with a low risk STarT Back score were excluded from this analysis, as from the ATLAS cohort, only one patient at low risk of poor outcome was referred to spinal specialist services
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BMC Musculoskeletal Disorders

ISSN: 1471-2474

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