{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T13:06:26Z","timestamp":1776863186479,"version":"3.51.2"},"reference-count":57,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:00:00Z","timestamp":1775865600000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","award":["202008060334"],"award-info":[{"award-number":["202008060334"]}],"id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2026,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background and Objective<\/jats:title>\n Low back pain (LBP) is a leading cause of work\u2010related disability. Although early tailored self\u2010management is advocated, current approaches remain generic. Classifying LBP by predominant pain phenotype (nociceptive, neuropathic, nociplastic) may enable targeted self\u2010management, yet practical tools for early or workplace use are limited. This study evaluated the reliability and validity of BACK\u2010on\u2010LINE, a self\u2010administered digital tool differentiating nociceptive and nociplastic pain to support early mechanism\u2010informed self\u2010management in working populations, benchmarked against established patient\u2010reported outcome measures (PROMs).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Employed adults with\n LBP<\/jats:styled-content>\n (\n n<\/jats:italic>\n \u2009=\u2009211) recruited from occupational settings completed\n BACK<\/jats:styled-content>\n \u2010on\u2010\n LINE<\/jats:styled-content>\n and\n PROMs<\/jats:styled-content>\n assessing pain (Numeric Pain Rating Scale;\n NPRS<\/jats:styled-content>\n ), disability (Roland\u2013Morris Disability Questionnaire;\n RMDQ<\/jats:styled-content>\n ), and psychosocial risk (\n STarT<\/jats:styled-content>\n Back Screening Tool;\n SBST<\/jats:styled-content>\n ). Reliability was assessed using internal consistency (Cronbach's\n \u03b1<\/jats:italic>\n ) and test\u2013retest reliability (intraclass correlation coefficient;\n ICC<\/jats:styled-content>\n ). Validity was examined through convergent validity with\n PROMs<\/jats:styled-content>\n , known\u2010groups validity comparing nociceptive and nociplastic subgroups, and criterion validity using receiver operating characteristic (\n ROC<\/jats:styled-content>\n ) analyses against reference standards (pain intensity, disability, chronicity, sickness absence).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Data from 136 participants (64% completion) were analysed.\n BACK<\/jats:styled-content>\n \u2010on\u2010\n LINE<\/jats:styled-content>\n classified 68.4% as nociceptive and 31.6% as nociplastic. Reliability was strong (\n \u03b1<\/jats:italic>\n \u2009=\u20090.83;\n ICC<\/jats:styled-content>\n \u2009=\u20090.88). Convergent validity was moderate, strongest with\n SBST<\/jats:styled-content>\n (\n r<\/jats:italic>\n \u2009=\u20090.67). Known\u2010groups validity was robust, with nociplastic participants reporting higher pain, disability and psychosocial risk (all\n p<\/jats:italic>\n \u2009<\u20090.001). Criterion validity was moderate (\n AUC<\/jats:styled-content>\n \u2009=\u20090.67\u20130.77), with\n BACK<\/jats:styled-content>\n \u2010on\u2010\n LINE<\/jats:styled-content>\n demonstrating comparable or superior discrimination to\n SBST<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n BACK<\/jats:styled-content>\n \u2010on\u2010\n LINE<\/jats:styled-content>\n shows good reliability and multi\u2010dimensional validity for self\u2010classifying pain phenotypes in working adults with\n LBP<\/jats:styled-content>\n , offering a scalable approach to support early mechanism\u2010informed self\u2010management in occupational health pathways.\n <\/jats:p>\n <\/jats:sec>\n \n Significance Statement<\/jats:title>\n This study provides robust initial evidence for a self\u2010administered digital tool BACK\u2010on\u2010LINE that enables working adults to self\u2010classify their low back pain into dominant pain mechanism phenotype. By supporting earlier, pain mechanism\u2010informed self\u2010management, 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ejp.70268","type":"journal-article","created":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T12:25:53Z","timestamp":1775910353000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["BACK<\/scp>\n \u2010on\u2010\n \n LINE\n \u2122<\/sup>\n <\/scp>\n : A Digital Pain Phenotyping Tool to Personalise Early Self\u2010Management of Low Back Pain: Reliability and Validity in Working Adults"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1489-7969","authenticated-orcid":false,"given":"Minghao","family":"Chen","sequence":"first","affiliation":[{"name":"School of Healthcare Sciences, Ty Dewi Sant, Heath Campus Cardiff University Cardiff UK"},{"name":"School of Acupuncture\u2010Moxibustion and Tuina & School of Health Preservation and Rehabilitation Nanjing University of Chinese Medicine Nanjing China"},{"name":"Biomechanics and Bioengineering Research Centre Versus Arthritis, Cardiff University Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4500-9327","authenticated-orcid":false,"given":"Valerie","family":"Sparkes","sequence":"additional","affiliation":[{"name":"School of Healthcare Sciences, Ty Dewi Sant, Heath Campus Cardiff University Cardiff UK"},{"name":"Biomechanics and Bioengineering Research Centre Versus Arthritis, Cardiff University Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1502-764X","authenticated-orcid":false,"given":"Liba","family":"Sheeran","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Highfield Campus University of Southampton Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S158847"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1302\/1358\u2010992x.2018.2.010"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/1358\u2010992x.2019.10.005"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnz075"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732319889354"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40945\u2010022\u201000129\u20102"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2016.01466"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.12.010"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638280310001639713"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000062"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2020.02.003"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392\u2010024\u201001845\u2010w"},{"key":"e_1_2_10_14_1","unstructured":"Chen M. V.Sparkes andL.Sheeran.2023.\u201cPatient Self\u2010Assessment Tool (Back\u2010on\u2010Line) for Early Targeted Self\u2010Management of Low Back Pain in the Workplace: Construct and Discriminate Validation Study [PO\u20101\u2010078] 2023 World Physiotherapy Dubai UAE.\u201dhttps:\/\/world.physio\/congress\u2010proceeding\/patient\u2010self\u2010assessment\u2010tool\u2010back\u2010linetm\u2010early\u2010targeted\u2010self\u2010management\u2010low."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/20552076251336281"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzy030"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586\u2010007\u20100577\u20106"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/pr9.0000000000000972"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136\u2010020\u201002546\u2010x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296\u2010019\u201004273\u20100"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665\u20109913(23)00098\u2010X"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.08.010"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001415"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2024.103242"},{"key":"e_1_2_10_25_1","volume-title":"SPSS for Windows Step by Step: A Simple Study Guide and Reference, 17.0 Update, 10\/e","author":"George D.","year":"2011"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508\u2010200501000\u201000009"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23563"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(11)60937\u20109"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2022.10802"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1179\/108331905X55776"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582\u2010024\u201000966\u20108"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2020.11.005"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.5395\/rde.2017.42.2.152"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893\u2010023\u201002307\u2010w"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010024\u201064059\u20108"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/1470785318805305"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2017.05.005"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181ec173d"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.14056"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/1088868310366253"},{"key":"e_1_2_10_41_1","volume-title":"National Institute for Health and Care Excellence Guidelines: Low Back Pain and Sciatica in Over 16s: Assessment and Management","author":"NICE","year":"2016"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7290"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2023.100537"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665\u20109913(23)00324\u20107"},{"key":"e_1_2_10_45_1","volume-title":"Foundations of Clinical Research: Applications to Practice","author":"Portney L. G.","year":"2009"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632\u2010198303000\u201000004"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2016.10.3.501"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.2221"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/jom.0000000000003087"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e318215f16a"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2012.03.002"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1179\/106698110X12640740712897"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X221100293"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.3138\/ptc.2014\u201085"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.3138\/ptc\u20102023\u20100050"},{"key":"e_1_2_10_56_1","volume-title":"International Classification of Functioning, Disability and Health (ICF)","author":"WHO","year":"2001"},{"key":"e_1_2_10_57_1","volume-title":"World Health Organization Guideline for Non\u2010Surgical Management of Chronic Primary Low Back Pain in Adults in Primary and Community Care Settings","author":"WHO","year":"2023"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23444"}],"container-title":["European Journal of Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejp.70268","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ejp.70268","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejp.70268","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T11:57:10Z","timestamp":1776859030000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ejp.70268"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":57,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/ejp.70268"],"URL":"https:\/\/doi.org\/10.1002\/ejp.70268","archive":["Portico"],"relation":{},"ISSN":["1090-3801","1532-2149"],"issn-type":[{"value":"1090-3801","type":"print"},{"value":"1532-2149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-10-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70268"}}