Psychometric Evaluation of the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) Tool: Factor Structure, Reliability, and Validity

Psychological characteristics consistently predict clinical outcomes for musculoskeletal pain conditions. The Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) tool assesses negative mood, fear-avoidance, and positive affect/coping. Psychometric testing of the tool is needed to guide clinical use. The purpose of this secondary analysis was to determine the OSPRO-YF factor structure (17- and 10-item versions) and test factor reliability and concurrent validity. Data from 2 musculoskeletal pain cohorts (n1=428; n2=440) were used. An exploratory factor analysis (EFA) identified the factor structure in the first cohort; a confirmatory factor analysis (CFA) validated the factor structure in the second cohort. EFA yielded 4 factors for the 17-item version (catastrophizing, positive coping, negative mood, fear-avoidance) and 3 factors for the 10-item version (negative coping, negative mood positive affect/coping). CFA indicated good fit for the 10-item and 17-item models. Factors from both versions demonstrated moderate to good test-retest reliability. Regression results revealed that factors from both versions contributed significantly to variance in pain intensity, disability, and quality of life. Results indicate the OSPRO-YF is a reliable and valid multidimensional psychological assessment tool for individuals with musculoskeletal pain. Future studies are needed to establish the OSPRO-YF as a prognostic and treatment monitoring tool. Perspective: This article presents the psychometric properties of the OSPRO-YF tool. Findings indicate the OSPRO-YF is a reliable and valid multidimensional psychological assessment tool for individuals with musculoskeletal pain. Implementation of the OSPRO-YF tool may better guide clinical decision making and may lead to improved musculoskeletal pain management strategies. (C) 2020 U.S. Association for the Study of Pain. Published by Elsevier Inc. All rights reserved.