Developing a screening checklist to identify women with back pain due to potentially undiagnosed fractures

Disease - Osteoporosis, back pain

Lead applicant - Dr Emma Clark

Organisation - University of Bristol

Type of grant - Clinical Studies

Status of grant - Active

Amount of the original award - £500,417.59

Start date - 1 January 2018

Reference - 21507

Public Summary

What are the aims of this research?

Osteoporosis is one of the most common musculoskeletal conditions in older women. The aim of this research is to produce and evaluate a simple screening checklist for GPs and other healthcare professionals to complete whenever a woman aged over 65 with back pain seeks healthcare.

Why is this research important?

Osteoporosis can lead to the development of osteoporotic vertebral fractures, meaning a broken bone in the back. Osteoporotic vertebral fractures can only be diagnosed through x-rays. However, at present not enough patients with back pain are being referred for an x-ray by their GP. This means many older women with vertebral fractures may remain undiagnosed, untreated, and therefore at a high risk of future fractures; even though medication is available to reduce their risk of broken bones by half when diagnosed correctly. The development of a simple checklist that can be used by any healthcare professional may help to prevent this.

This study will consist of two stages. Firstly, the researchers will work with a group of older women who have had back pain in the last four months, asking them questions, and carrying out a physical examination and x-rays. Statistics will be used to identify which questions and parts of the physical examination should go on the checklist. Secondly, they will follow up with this group of women to investigate what happened after the x-ray (for example they might have physiotherapy, or start on a new medication) to see if the checklist is likely to be helpful and save the NHS money in the longer term.

How will the findings benefit patients?

No previous studies, or trials, of checklists to identify people who may have an osteoporotic vertebral fracture have been carried out, apart from this researcher’s previous study. This project will build on their previous work and help develop a checklist that is cost-effective for the NHS to use for all older women presenting with back pain. In the future, it is hoped this tool could be turned into an online tool that could be freely available for anyone to use.