To describe the clinical use of patient-reported outcome measures (PROMs) and screening tools (STs) for low back pain (LBP) in clinics of chiropractic teaching institutions in the United States.


A descriptive analysis was completed with data collection achieved between June 2018 and March 2019. PROMs/STs were classified as disability/functional measures, pain measures, psychosocial measures, and other measures. Frequencies of use of PROM/ST instruments were calculated.


Representatives from 18 of 19 chiropractic institutions (94.75%) provided a description of PROM/ST use for LBP in their teaching clinics. Seventeen institutions (94.4%) reported the routine clinical use of PROMs/STs for LBP. Disability/functional measures were the most common type of instruments used, followed by pain measures, psychosocial measures, and others. The 4 most common individual PROMs/STs reported were (1) Oswestry Disability Index, (2) a variation of a pain rating scale, (3) Keele STarT Back Tool, and (4) Patient Specific Functional Scale. Six out of 18 (33%) institutions reported the use of a PROM/ST specifically designed to focus on psychosocial influences.


Most chiropractic institution teaching clinics in the United States reported the clinical use of PROMs/STs for patients presenting with LBP. This mirrors trends in chiropractic literature of increasing use of PROMs/STs. A minority of institutions described the clinical use of a PROM/ST specifically designed to detect psychosocial influences.

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Author notes

Jesse Cooper is senior staff chiropractor in the Department of Chiropractic Medicine at Baylor Scott & White Health (300A University Boulevard, Round Rock, TX 78665; jesse.cooper.dc@gmail.com). Jordan Gliedt is an assistant professor in the Department of Neurosurgery at the Medical College of Wisconsin (1155 N. Mayfair Road, Milwaukee, WI 53226; jgliedt@mcw.edu). Katherine Pohlman is the director of research at Parker University (2540 Walnut Hill Lane, Dallas, TX 75229; kpohlman@parker.edu).

Concept development: JCC. Design: JCC, KAP. Supervision: JCC. Data collection/processing: JCC, JAG, KAP. Analysis/interpretation: JCC, JAG, KAP. Literature search: JCC, JAG, KAP. Writing: JCC, JAG, KAP. Critical review: JCC, JAG, KAP.