{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T11:33:07Z","timestamp":1769167987770,"version":"3.49.0"},"reference-count":51,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,1,5]],"date-time":"2025-01-05T00:00:00Z","timestamp":1736035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In recent years, delayed elective care and growing waiting lists increasingly resulted in postponed surgeries for patients with chronic back and leg pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To develop, implement, and evaluate the feasibility of a triage tool for patients with chronic back and\/or leg pain to identify those eligible for referral to spinal cord stimulation (SCS) consultation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A triage tool was developed, based on Dutch SCS guidelines, literature review and expert panel consultation. The triage process was detected and implemented in collaboration with a multidisciplinary team, prior to first orthopaedic consultation. Feasibility, reliability and predictive accuracy were analysed as part of the evaluation of the triage tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The triage indicators included: Pain location (leg\/mixed), DN4\u2009&gt;\u20093, pain duration \u2265\u20093\u2009months, leg pain\u2009\u2265\u2009back pain and NPRS leg pain \u2265\u20095. The triage tool was applied on patients on the orthopaedic waiting list, followed by a full orthopaedic review if they were not excluded. A total of 1025 orthopaedic patients with chronic back and leg pain were assessed with the triage tool. The triage tool was evaluated as feasible (mean System Usability Score 74.2 [SD 11.5]), reliable (inter\u2010rater reliability [Fleiss' Kappa 0.79], intra\u2010rater reliability [Cohen's Kappa 0.89]) and accurate (sensitivity [100%], specificity [98.8%], positive predictive value [40%] and negative predictive value [100%]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early triage of potential SCS candidates potentially supports rapid and appropriate care allocation, shortens waiting list time and improves clinical outcomes. Future research should explore strategies to optimise the tool's performance in identifying patients most likely to benefit from SCS therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>A novel triage tool was developed to identify patients with chronic back and leg pain for an early referral to SCS. This tool, evaluated for feasibility, reliability, and predictive accuracy, shows promise in reducing waiting times and improving patient selection. It can be a prelude to the further development of decision support for SCS and an acceleration in the care process for SCS candidates.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.4780","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T01:37:06Z","timestamp":1736127426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and Feasibility Study of a Triage Tool for Early Referral to Spinal Cord Stimulation for Patients With Chronic Low Back and Leg Pain"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5758-4954","authenticated-orcid":false,"given":"Ferdinand","family":"Bastiaens","sequence":"first","affiliation":[{"name":"Department of Research Sint Maartenskliniek  Nijmegen The Netherlands"},{"name":"Department of Anesthesiology, Pain and Palliative Medicine Radboudumc  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miranda L.","family":"van Hooff","sequence":"additional","affiliation":[{"name":"Department of Research Sint Maartenskliniek  Nijmegen The Netherlands"},{"name":"Department of Orthopedic Surgery Radboudumc  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivar J.","family":"Bruaset","sequence":"additional","affiliation":[{"name":"Anesthesiology Department Sint Maartenskliniek  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Els","family":"van den Eede","sequence":"additional","affiliation":[{"name":"Anesthesiology Department Sint Maartenskliniek  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasja J. G.","family":"Maandag","sequence":"additional","affiliation":[{"name":"Chronic Pain Department Sint Maartenskliniek  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erkan","family":"Kurt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Radboudumc  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique C. M.","family":"Schel\u2010Huisman","sequence":"additional","affiliation":[{"name":"Chronic Pain Department Sint Maartenskliniek  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica T.","family":"Wegener","sequence":"additional","affiliation":[{"name":"Chronic Pain Department Sint Maartenskliniek  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kris C. P.","family":"Vissers","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain and Palliative Medicine Radboudumc  Nijmegen The Netherlands"},{"name":"Chronic Pain Department Sint Maartenskliniek  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,5]]},"reference":[{"issue":"3","key":"e_1_2_8_2_1","first-page":"114","article-title":"Determining What Individual SUS Scores Mean: Adding an Adjective Rating Scale","volume":"4","author":"Bangor A.","year":"2009","journal-title":"Journal of Usability Studies"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/2049463720948092"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurom.2023.10.188"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2021.11.014"},{"issue":"194","key":"e_1_2_8_6_1","first-page":"4","article-title":"SUS\u2010A Quick and Dirty Usability Scale","volume":"189","author":"Brooke J.","year":"1996","journal-title":"Usability Evaluation in Industry"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526\u20104637.2009.00632.x"},{"key":"e_1_2_8_8_1","unstructured":"Centers for Medicare and Medicaid Services.2018.\u201cLocal Coverage Determination (LCD): Spinal Cord Stimulation for Chronic Pain (L36035).\u201dhttps:\/\/www.cms.gov\/medicare\u2010coverage\u2010database\/view\/lcd.aspx?lcdId=36035&ver=26."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2015.1036696"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13103"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12325"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f2125"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12208"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.13054"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurom.2022.02.232"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2022.2160837"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002035"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj\/2016.19.E33"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurom.2023.11.004"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhip.2022.100254"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000002213"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzab092"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12126"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2006.21.6.6"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/10447318.2018.1455307"},{"issue":"3","key":"e_1_2_8_26_1","first-page":"158","article-title":"Item Benchmarks for the System Usability Scale","volume":"13","author":"Lewis J. 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