Optimal Screening for Prediction of Referral and Outcome (OSPRO) for Musculoskeletal Pain Conditions: Results From the Validation Cohort.

Study Design Observational, prospective cohort. Background Musculoskeletal pain is a common reason to seek health care, and earlier nonpharmacological treatment and enhancement of personalized care options are 2 high-priority areas. Validating concise assessment tools is an important step toward 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 demographic, clinical, and comorbidity questionnaires 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 (OSPRO-ROS) and yellow flag (OSPRO-YF) tools and planned covariates (accounting for comorbidities and established demographic and clinical factors). Results The 10-item OSPRO-YF 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-ROS tool added to a predictive model for quality of life (mental summary score), and 13 additional items of the OSPRO-ROS+ 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-ROS and OSPRO-YF tools statistically improved prediction of multiple 12-month outcomes. The additional variance explained was small, and future research is necessary to determine whether these tools can be used as measurement adjuncts to improve management of musculoskeletal pain. J Orthop Sports Phys Ther 2018;48(6):460-475. Epub 7 Apr 2018. doi:10.2519/jospt.2018.7811.