Study Design
Observational, prospective cohort
Background
Musculoskeletal pain is a common reason to seek healthcare and earlier non-pharmacological treatment and enhancement of personalized care options are two high priority areas. Validating concise assessment tools is an important step in establishing better care pathways.
Objectives
To determine the predictive validity of Optimal Screening for Prediction of Referral and Outcome (OSPRO) tools for individuals with neck, low back, shoulder, or knee pain.
Methods
A convenience sample (n = 440) was gathered by Orthopaedic Physical Therapy-Investigator Network clinics (n = 9). Participants completed questionnaires for demographic, clinical, comorbidity, and the OSPRO tools and were followed for 12-month outcomes in pain intensity, region-specific disability, quality of life, and comorbidity change. Analyses predicted these 12-month outcomes with models that included the OSPRO review of systems and yellow flag tools and planned covariates (accounting for comorbidities and established demographic and clinical factors).
Results
The 10 item OSPRO yellow flag tool (baseline and 4 week change score) consistently added to predictive models for 12-month pain intensity, region-specific disability, and quality of life. The 10 item OSPRO review of system tool added to a predictive model for quality of life (mental summary score) and 13 additional items of the OSPRO review of system+ tool added to prediction of 12-month comorbidity change. Other consistent predictors included age, race, income, previous episode of pain in same region, comorbidity number, and baseline measure for the outcome of interest.
Conclusion
The OSPRO review of system and yellow flag tools statistically improved prediction of multiple 12 month outcomes. The additional variance explained was small and future research is necessary to determine if these tools can be used as measurement adjuncts to improve management of musculoskeletal pain.