Keele STarT Back Screening Tool
Stratifies low back pain patients into risk groups to guide treatment pathway selection
- Highest activation tier
- Recommended
- How it is scored
- Scored in code; a stated value is compared only from the structured summary or a supplied value
- Scoring type
- point sum
- Care settings
- Inpatient, Outpatient
When it activates
Scribeable activates a calculator from the encounter. The Keele STarT Back Screening Tool can activate when the transcript or pasted chart context documents any of these:
- Low back pain risk stratification
- Back pain treatment pathway selection
- Chronic back pain psychosocial screening
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: M54.
Inputs the note needs
2 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| STarT Back total score (0-9) | symptom | ||
| Psychosocial subscore items 5-9 (0-4) | symptom |
Scoring
9 items. Total 0-9. Psychosocial subscore (items 5-9): 0-4.
Interpretation
Total ≤3: Low risk — routine primary care. Total ≥4 + subscore <4: Medium risk — physical therapy. Total ≥4 + subscore ≥4: High risk — combined physical and psychological intervention.
Evidence
Sources carried in Scribeable's citation registry for this calculator; guideline version: Hill 2008.
- Hill JC et al. A primary care back pain screening tool: identifying patient subgroups for initial treatment (STarT Back)Hill et al. (STarT Back) 2008 · 2008 · Keele University · Level I · link last verified 2026-03-28
How Scribeable handles it in the note
When an encounter activates the Keele STarT Back Screening Tool (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.
The score is computed in code from the resolved inputs, not recalled by the language model. A stated Keele STarT Back Screening Tool value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.
Classified as a questionnaire: a patient-reported or clinician-rated instrument, where a spare activation carries low harm.
See it activate on your own encounter
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