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 == | ||
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> | |||
== Description == | |||
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> | |||
== | |||
== Intended Population == | == 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" /> | |||
# 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) | |||
== 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 | == 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" /> | |||
* 17-item: 85% | |||
* 10-item: 79% | |||
* 7-item: 75% | |||
=== | === Resources === | ||
[https://www.orthopt.org/yf/OSPRO_YF_Tool_questions.pdf OSPRO-YF Assessment Tool] | |||
[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]
- Negative mood:
- Patient Health Questionnaire-9 (PHQ-9)
- State-Trait Anxiety Inventory (STAI)
- State-Trait Anger Expression Inventory (STAXI)
- Fear avoidance:
- Fear-Avoidance Beliefs Questionnaire -Physical Activity (FABQ-PA)
- 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)
- Self-Efficacy for Rehabilitation Outcome Scale (SER)
- Chronic Pain Acceptance Questionnaire (CPAQ)
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)
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 Scoring Portal
References[edit | edit source]
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 6.0 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.
- ↑ 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.
- ↑ 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.