BACK-on-LINE™: A Digital Pain Phenotyping Tool to Personalise Early Self-Management of Low Back Pain: Reliability and Validity in Working Adults

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2026-04-11 DOI:10.1002/ejp.70268

Minghao Chen, Valerie Sparkes, Liba Sheeran

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引用次数: 0

Abstract

Background and Objective

Low back pain (LBP) is a leading cause of work-related disability. Although early tailored self-management is advocated, current approaches remain generic. Classifying LBP by predominant pain phenotype (nociceptive, neuropathic, nociplastic) may enable targeted self-management, yet practical tools for early or workplace use are limited. This study evaluated the reliability and validity of BACK-on-LINE, a self-administered digital tool differentiating nociceptive and nociplastic pain to support early mechanism-informed self-management in working populations, benchmarked against established patient-reported outcome measures (PROMs).

Methods

Employed adults with LBP (n = 211) recruited from occupational settings completed BACK-on-LINE and PROMs assessing pain (Numeric Pain Rating Scale; NPRS), disability (Roland–Morris Disability Questionnaire; RMDQ), and psychosocial risk (STarT Back Screening Tool; SBST). Reliability was assessed using internal consistency (Cronbach's α) and test–retest reliability (intraclass correlation coefficient; ICC). Validity was examined through convergent validity with PROMs, known-groups validity comparing nociceptive and nociplastic subgroups, and criterion validity using receiver operating characteristic (ROC) analyses against reference standards (pain intensity, disability, chronicity, sickness absence).

Results

Data from 136 participants (64% completion) were analysed. BACK-on-LINE classified 68.4% as nociceptive and 31.6% as nociplastic. Reliability was strong (α = 0.83; ICC = 0.88). Convergent validity was moderate, strongest with SBST (r = 0.67). Known-groups validity was robust, with nociplastic participants reporting higher pain, disability and psychosocial risk (all p < 0.001). Criterion validity was moderate (AUC = 0.67–0.77), with BACK-on-LINE demonstrating comparable or superior discrimination to SBST.

Conclusions

BACK-on-LINE shows good reliability and multi-dimensional validity for self-classifying pain phenotypes in working adults with LBP, offering a scalable approach to support early mechanism-informed self-management in occupational health pathways.

Significance Statement

This study provides robust initial evidence for a self-administered digital tool BACK-on-LINE that enables working adults to self-classify their low back pain into dominant pain mechanism phenotype. By supporting earlier, pain mechanism-informed self-management, it addresses a key gap in workplace back pain support, which is often generic advice poorly tailored. The tool's strength lies in scalability, early application and workplace relevance, outperforming a widely used prognostic tool in this context.

查看原文本刊更多论文

Back - online™：数字化疼痛表型工具个性化早期腰痛自我管理：工作成年人的可靠性和有效性。

背景和目的：腰痛（LBP）是导致工作致残的主要原因。虽然提倡早期的量身定制的自我管理，但目前的方法仍然是通用的。根据主要的疼痛表型（伤害性、神经性、伤害性）对腰痛进行分类可能会实现有针对性的自我管理，但早期或工作场所使用的实用工具有限。本研究评估了back - online的可靠性和有效性，back - online是一种自我管理的数字工具，可区分伤害性和伤害性疼痛，以支持工作人群早期机制知情的自我管理，以已建立的患者报告结果测量（PROMs）为基准。方法：从职业环境中招募有腰痛的成年雇员（n = 211），完成Back - online和PROMs评估疼痛（数字疼痛评定量表；NPRS）、残疾（Roland-Morris残疾问卷；RMDQ）和心理社会风险（STarT Back Screening Tool； SBST）。信度采用内部一致性（Cronbach’s α）和重测信度（类内相关系数；ICC）进行评估。通过与PROMs的收敛效度、比较伤害性和伤害性亚组的已知组效度和对照参考标准（疼痛强度、残疾、慢性、缺勤）的受试者工作特征（ROC）分析来检验效度。结果：136名参与者（完成64%）的数据被分析。back - online分类68.4%为伤害性，31.6%为伤害性。信度较强（α = 0.83; ICC = 0.88）。收敛效度中等，以SBST最强（r = 0.67）。结论：back - online在腰痛患者自我分类疼痛表型方面显示出良好的信度和多维效度，为支持职业健康途径中早期机制知情的自我管理提供了一种可扩展的方法。意义声明：本研究为自我管理的数字工具back - online提供了强有力的初步证据，该工具使工作成年人能够将腰痛自我分类为显性疼痛机制表型。通过支持更早的、了解疼痛机制的自我管理，它解决了工作场所背痛支持方面的一个关键空白，这通常是泛泛的、量身定制的建议。该工具的优势在于可扩展性、早期应用和工作场所相关性，在这种情况下优于广泛使用的预测工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.