Discussion
LBP
Recent calls to action for lessening the societal burden of LBP have prioritized identification of effective treatment approaches that can be scaled across different health systems.Risk-stratified care for LBP using the SBST has been tested now in 5 large, randomized trials with mixed results.Interestingly, there were higher raw costs associated with the risk-stratified approach compared with usual care. This unexpected finding was likely due to the increased amount of physical therapy utilization in the risk-stratified care group because we did not observe differences in the treatment groups for other health care utilization variables, like imaging or surgery. Most patients in the usual care group ended up with referrals to physical therapy outside the framework of the study, but the type and dosing of care they received is unknown. A formal cost-effectiveness analysis may help validate these findings.