Inter-rater reliability and validity of the screenassist lumbar questionnaire: a pilot study

The purpose of this study was to examine the validity and test-retest reliability of the ScreenAssist Lumbar Questionnaire (SALQ). If a high degree of reliability and validity could be determined, the questionnaire could provide physical therapists with a formal instrument to assist with the identification of patients with nonmusculoskeletal back pain or emergent musculoskeletal causes of back pain requiring referral to an alternate medical provider.

Participants were patients presenting to an internal medicine physician's office with the main complaint of low back pain over a 6 months period. ScreenAssist Lumbar Questionnaire was performed twice on each patient within 48 hours of the appointment. A 4-month post-visit chart review was performed to compare scores and recommendations made by the questionnaire with the assessment and diagnosis made by the physician.

The SALQ demonstrated a sensitivity of 0·100 (95% CI: 0·689-0·100) and specificity of 0·786 (95%CI: 0·492-0·951) compared to the assessment and diagnosis performed by the primary care physician. Overall, regarding the recommendation for referral, there was agreement on 20 of the 21 patients with a Kappa of 0·798.

The overall test-retest reliability and validity for referral recommendation were high, which indicates that the SALQ may serve as an alternative to the use of red flags in isolation to assist the physical therapist in determining the need for medical referral as the practice continues to progress toward direct access. The positive outcome of this study supports the possible future benefit of the SALQ.