Optimal Screening for Prediction of Referral and Outcome Yellow Flag: Difference between revisions

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'''Original Editor '''- [[User:Carina Therese Magtibay|Carina Therese Magtibay]]
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== Objective ==
'''Original Editor '''- [[User:User Name|User Name]]
Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) is a multidimensional screening tool used to assess psychosocial factors in individuals with musculoskeletal pain.<ref name=":1">Butera KA, George SZ, Lentz TA. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078059/#:~:text=musculoskeletal%20pain%20conditions.-,The%20Optimal%20Screening%20for%20Prediction%20of%20Referral%20and%20Outcome%20Yellow,needed%20to%20guide%20clinical%20use. Psychometric evaluation of the optimal screening for prediction of referral and outcome yellow flag (OSPRO-YF) tool: factor structure, reliability, and validity.] The Journal of Pain. 2020 May 1;21(5-6):557-69.</ref>


'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}  &nbsp;  
== Description ==
</div>  
The presence of yellow flags contributes to a patient's rehabilitation and overall pain experience<ref>Beneciuk JM, Fritz JM, George SZ. [https://www.jospt.org/doi/full/10.2519/jospt.2014.5178 The STarT Back Screening Tool for prediction of 6-month clinical outcomes: relevance of change patterns in outpatient physical therapy settings]. journal of orthopaedic & sports physical therapy. 2014 Sep;44(9):656-64.</ref><ref>Van Wyngaarden JJ, Noehren B, Archer KR. [https://onlinelibrary.wiley.com/doi/full/10.1111/jabr.12165 Assessing psychosocial profile in the physical therapy setting]. Journal of Applied Biobehavioral Research. 2019 Jun;24(2):e12165.</ref>. Clinical practice guidelines<ref>Kelley MJ, Shaffer MA, Kuhn JE, Michener LA, Seitz AL, Uhl TL, Godges JJ, McClure PW, Altman RD, Davenport T, Davies GJ. [https://www.jospt.org/doi/full/10.2519/jospt.2013.0302 Shoulder pain and mobility deficits: adhesive capsulitis: clinical practice guidelines linked to the international classification of functioning, disability, and health from the Orthopaedic Section of the American Physical Therapy Association.] Journal of orthopaedic & sports physical therapy. 2013 May;43(5):A1-31.</ref><ref>Delitto A, George SZ, Van Dillen L, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges JJ, Beneciuk JM, Bishop MD, Kramer CD. [https://www.jospt.org/doi/full/10.2519/jospt.2012.42.4.A1 Low back pain: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association]. Journal of orthopaedic & sports physical therapy. 2012 Apr;42(4):A1-57.</ref> recommend evaluation of psychological components for pain conditions. OSPRO-YF is useful in understanding the influence of psychosocial characteristics on a patient's prognosis and treatment response. <ref name=":0">Lentz TA, Beneciuk JM, Bialosky JE, Zeppieri Jr G, Dai Y, Wu SS, George SZ. [https://www.jospt.org/doi/epdf/10.2519/jospt.2016.6487 Development of a yellow flag assessment tool for orthopaedic physical therapists: results from the optimal screening for prediction of referral and outcome (OSPRO) cohort.] journal of orthopaedic & sports physical therapy. 2016 May;46(5):327-43.</ref>
== Objective<br> ==


== Intended Population<br> ==
== Intended Population ==
Designed to help healthcare practitioners identify pain-related psychological characteristics in outpatient orthopedic settings, OSPRO-YF is a reliable and valid tool for '''individuals with musculoskeletal conditions'''.<ref>George SZ, Beneciuk JM, Lentz TA, Wu SS, Dai Y, Bialosky JE, Zeppieri Jr G. [https://www.jospt.org/doi/10.2519/jospt.2018.7811 Optimal screening for prediction of referral and outcome (OSPRO) for musculoskeletal pain conditions: results from the validation cohort.] Journal of Orthopaedic & Sports Physical Therapy. 2018 Jun;48(6):460-75.</ref>


== Method of Use  ==
== Method of Use  ==
OSPRO-YF has 7-item, 10-item and 17-item versions developed from validated psychological questionnaires across domains associated with pain vulnerability (negative mood, fear avoidance), and resilience (positive affect/coping.)<ref name=":0" />
OSPRO-YF accurately estimates scores from these unidimensional psychological questionnaires:<ref name=":0" />


== Reference<br>  ==
# Negative mood:
#* [[Patient  Health  Questionnaire]]-9  (PHQ-9)
#* State-Trait Anxiety Inventory  (STAI)
#* State-Trait  Anger   Expression   Inventory (STAXI)
# Fear avoidance:
#*[[Fear Avoidance Belief Questionnaire|Fear-Avoidance Beliefs Questionnaire]] -Physical Activity (FABQ-PA)
#* [[Fear Avoidance Belief Questionnaire|Fear-Avoidance Beliefs Questionnaire]] - Work (FABQ-W)
#*[[Pain   Catastrophizing Scale]] (PCS)
#* Tampa  Scale  of  [[Kinesiophobia]]-11  (TSK-11)
#* Pain  Anxiety  Symptoms  Scale-20 (PASS-20)
# Positive affect/Coping
#* [[Pain Self-Efficacy Questionnaire (PSEQ)|Pain Self-Efficacy Questionnaire]] (PSEQ)
#* Self-Efficacy for Rehabilitation Outcome Scale (SER)
#* Chronic   Pain   Acceptance   Questionnaire  (CPAQ)


== Evidence ==
== Scoring ==
As OSPRO-YF summarizes 11 psychological questionnaires, it is not scored like a conventional screening tool. ''Quartile scores are used instead of cutoff scores for consistency and assessment of a wide range of outpatient orthopedic patients.<ref name=":0" />''
 
'''Yellow Flag Indicators:'''<ref name=":0" />
 
* scores that are in the top quartile (top 25%) for negative psychological questionnaires  (Negative Mood and Fear Avoidance questionnaires)
* scores that are in the bottom quartile (bottom 25%) for positive psychological questionnaires (Positive Affect/Coping questionnaires).
 
== Evidence ==


=== Reliability  ===
=== Reliability  ===


=== Validity ===
'''OSPRO-YF 17-item version'''<ref name=":1" />
{| class="wikitable"
|+
!
!ICC
!p
|-
|catastrophizing factor
|0.83
|<0.01
|-
|negative mood factor
|0.89
|<0.01
|-
|fear-avoidance factor
|0.83
|<0.01
|-
|positive affect/coping factor
|0.63
|<0.01
|-
|17-item simple summary score
|0.88
|<0.001
|}
'''OSPRO-YF 10-item version'''<ref name=":1" />
{| class="wikitable"
|+
!
!ICC
!p
|-
|negative coping factor
|0.80
|<0.01
|-
|negative mood factor
|0.86
|<0.01
|-
|positive affect/coping factor
|0.65
|<0.01
|-
|10-item simple summary score
|0.85
|<0.001
|}
 
* Excellent reliability (ICC values >0.9)
* Good reliability (ICC values=0.75 to 0.9)
* Moderate reliability (ICC values=0.5 to 0.75)
 
<ref>Koo TK, Li MY. [https://www.sciencedirect.com/science/article/abs/pii/S1556370716000158 A guideline of selecting and reporting intraclass correlation coefficients for reliability research.] Journal of chiropractic medicine. 2016 Jun 1;15(2):155-63.</ref>
 
=== Validity ===
'''OSPRO-YF 17-item tool'''<ref name=":1" />
 
* The catastrophizing and positive affect/coping factors significantly contributed to the average daily pain measure (p<0.01).
* Catastrophizing, fear avoidance, and positive affect/coping factors significantly contributed to disability (p<0.01).
* Catastrophizing, negative mood, and positive affect/coping factors significantly contributed to the mental quality of life and physical quality of life measures (p<0.01).
 
 
'''OSPRO-YF 10-item tool'''<ref name=":1" />
 
* Positive affect/coping, negative coping, and negative mood significantly contributed to the mental quality of life measure (p<0.01)
* Positive affect/coping and negative coping factors significantly contributed to average daily pain, disability, and physical quality of life measures (p<0.01).
 
=== Accuracy ===
Longer versions provide greater accuracy:<ref name=":0" />


=== Responsiveness  ===
* 17-item: 85%
* 10-item: 79%
* 7-item: 75%


=== Miscellaneous<span style="font-size: 20px; font-weight: normal;" class="Apple-style-span"></span><br>  ===
=== Resources ===
[https://www.orthopt.org/yf/OSPRO_YF_Tool_questions.pdf OSPRO-YF Assessment Tool]


== Links  ==
[https://www.orthopt.org/yf/ OSPRO-YF Assessment Tool Scoring Portal]


== References  ==
== References  ==


<references />
<references />
[[Category:Outcome Measures]]
[[Category:Mental Health - Outcome Measures]]
[[Category:Musculoskeletal/Orthopaedics]]
[[Category:Pain Screening Tools]]
[[Category:Pain]]

Latest revision as of 12:30, 17 October 2023

Original Editor - Carina Therese Magtibay

Objective[edit | edit source]

Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) is a multidimensional screening tool used to assess psychosocial factors in individuals with musculoskeletal pain.[1]

Description[edit | edit source]

The presence of yellow flags contributes to a patient's rehabilitation and overall pain experience[2][3]. Clinical practice guidelines[4][5] recommend evaluation of psychological components for pain conditions. OSPRO-YF is useful in understanding the influence of psychosocial characteristics on a patient's prognosis and treatment response. [6]

Intended Population[edit | edit source]

Designed to help healthcare practitioners identify pain-related psychological characteristics in outpatient orthopedic settings, OSPRO-YF is a reliable and valid tool for individuals with musculoskeletal conditions.[7]

Method of Use[edit | edit source]

OSPRO-YF has 7-item, 10-item and 17-item versions developed from validated psychological questionnaires across domains associated with pain vulnerability (negative mood, fear avoidance), and resilience (positive affect/coping.)[6]

OSPRO-YF accurately estimates scores from these unidimensional psychological questionnaires:[6]

  1. Negative mood:
  2. Fear avoidance:
  3. Positive affect/Coping

Scoring[edit | edit source]

As OSPRO-YF summarizes 11 psychological questionnaires, it is not scored like a conventional screening tool. Quartile scores are used instead of cutoff scores for consistency and assessment of a wide range of outpatient orthopedic patients.[6]

Yellow Flag Indicators:[6]

  • scores that are in the top quartile (top 25%) for negative psychological questionnaires (Negative Mood and Fear Avoidance questionnaires)
  • scores that are in the bottom quartile (bottom 25%) for positive psychological questionnaires (Positive Affect/Coping questionnaires).

Evidence[edit | edit source]

Reliability[edit | edit source]

OSPRO-YF 17-item version[1]

ICC p
catastrophizing factor 0.83 <0.01
negative mood factor 0.89 <0.01
fear-avoidance factor 0.83 <0.01
positive affect/coping factor 0.63 <0.01
17-item simple summary score 0.88 <0.001

OSPRO-YF 10-item version[1]

ICC p
negative coping factor 0.80 <0.01
negative mood factor 0.86 <0.01
positive affect/coping factor 0.65 <0.01
10-item simple summary score 0.85 <0.001
  • Excellent reliability (ICC values >0.9)
  • Good reliability (ICC values=0.75 to 0.9)
  • Moderate reliability (ICC values=0.5 to 0.75)

[8]

Validity[edit | edit source]

OSPRO-YF 17-item tool[1]

  • The catastrophizing and positive affect/coping factors significantly contributed to the average daily pain measure (p<0.01).
  • Catastrophizing, fear avoidance, and positive affect/coping factors significantly contributed to disability (p<0.01).
  • Catastrophizing, negative mood, and positive affect/coping factors significantly contributed to the mental quality of life and physical quality of life measures (p<0.01).


OSPRO-YF 10-item tool[1]

  • Positive affect/coping, negative coping, and negative mood significantly contributed to the mental quality of life measure (p<0.01)
  • Positive affect/coping and negative coping factors significantly contributed to average daily pain, disability, and physical quality of life measures (p<0.01).

Accuracy[edit | edit source]

Longer versions provide greater accuracy:[6]

  • 17-item: 85%
  • 10-item: 79%
  • 7-item: 75%

Resources[edit | edit source]

OSPRO-YF Assessment Tool

OSPRO-YF Assessment Tool Scoring Portal

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Butera KA, George SZ, Lentz TA. Psychometric evaluation of the optimal screening for prediction of referral and outcome yellow flag (OSPRO-YF) tool: factor structure, reliability, and validity. The Journal of Pain. 2020 May 1;21(5-6):557-69.
  2. ↑ Beneciuk JM, Fritz JM, George SZ. The STarT Back Screening Tool for prediction of 6-month clinical outcomes: relevance of change patterns in outpatient physical therapy settings. journal of orthopaedic & sports physical therapy. 2014 Sep;44(9):656-64.
  3. ↑ Van Wyngaarden JJ, Noehren B, Archer KR. Assessing psychosocial profile in the physical therapy setting. Journal of Applied Biobehavioral Research. 2019 Jun;24(2):e12165.
  4. ↑ Kelley MJ, Shaffer MA, Kuhn JE, Michener LA, Seitz AL, Uhl TL, Godges JJ, McClure PW, Altman RD, Davenport T, Davies GJ. Shoulder pain and mobility deficits: adhesive capsulitis: clinical practice guidelines linked to the international classification of functioning, disability, and health from the Orthopaedic Section of the American Physical Therapy Association. Journal of orthopaedic & sports physical therapy. 2013 May;43(5):A1-31.
  5. ↑ Delitto A, George SZ, Van Dillen L, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges JJ, Beneciuk JM, Bishop MD, Kramer CD. Low back pain: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association. Journal of orthopaedic & sports physical therapy. 2012 Apr;42(4):A1-57.
  6. ↑ 6.0 6.1 6.2 6.3 6.4 6.5 Lentz TA, Beneciuk JM, Bialosky JE, Zeppieri Jr G, Dai Y, Wu SS, George SZ. Development of a yellow flag assessment tool for orthopaedic physical therapists: results from the optimal screening for prediction of referral and outcome (OSPRO) cohort. journal of orthopaedic & sports physical therapy. 2016 May;46(5):327-43.
  7. ↑ George SZ, Beneciuk JM, Lentz TA, Wu SS, Dai Y, Bialosky JE, Zeppieri Jr G. Optimal screening for prediction of referral and outcome (OSPRO) for musculoskeletal pain conditions: results from the validation cohort. Journal of Orthopaedic & Sports Physical Therapy. 2018 Jun;48(6):460-75.
  8. ↑ Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of chiropractic medicine. 2016 Jun 1;15(2):155-63.
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