Optimal Screening for Prediction of Referral and Outcome Yellow Flag

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Original Editor - Carina Therese Magtibay

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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:
    • Patient  Health  Questionnaire-9  (PHQ-9)
    • State-Trait Anxiety Inventory  (STAI)
    • State-Trait  Anger   Expression   Inventory (STAXI)
  2. Fear avoidance:
    • Fear-Avoidance Beliefs Questionnaire  (FABQ)
    • Pain   Catastrophizing Scale (PCS)
    • Tampa  Scale  of  Kinesiophobia-11  (TSK-11)
    • Pain  Anxiety  Symptoms  Scale-20 (PASS-20)
  3. Positive affect/Coping
    • Pain Self-Efficacy Questionnaire (PSEQ)
    • Self-Efficacy for Rehabilitation Outcome Scale (SER)
    • Chronic   Pain   Acceptance   Questionnaire  (CPAQ)

Evidence[edit | edit source]

Reliability[edit | edit source]

  • 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]

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

Validity[edit | edit source]

Responsiveness[edit | edit source]

Miscellaneous
[edit | edit source]

Links[edit | edit source]

OSPRO-YF Assessment Tool

OSPRO-YF Assessment Tool Scoring Portal

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 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 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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