Kim Billy I, Wu Kevin A, Luo Emily J, Morriss Nicholas J, Cabell Grant H, Lentz Trevor A, Lau Brian C
Duke University Department of Orthopaedic Surgery, Durham, NC, USA.
JSES Int. 2024 Jul 8;8(5):1115-1121. doi: 10.1016/j.jseint.2024.06.014. eCollection 2024 Sep.
The Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) Tool is a 10-item multidimensional screening tool utilized to evaluate pain-related psychological traits in individuals with musculoskeletal pain conditions. The validity of postoperatively collected OSPRO-YF is unclear. This study sought to assess validity of the OSPRO-YF by comparing it to patient-reported outcome scores in both preoperative and postoperative settings.
The authors hypothesized that OSPRO-YF overall score would correlate with shoulder and global function PROs at preoperative and postoperative timepoints.
A review of 101 patients undergoing shoulder surgery by one sports medicine orthopedic surgeon at a large academic institution was conducted. 90 and 54 patients had complete preoperative and postoperative patient-reported outcome responses. OSPRO-YF, American Shoulder and Elbow Surgeons (ASES) Evaluation Form, and Patient-Reported Outcomes Measurement Information System Computer Adaptive Test (PROMIS-CAT) were routinely administered before and after surgery at the senior author's clinic visits. Concurrent validity of OSPRO-YF at either timepoint was assessed by comparing scores with PROs cross-sectionally using Pearson correlations and multiple comparison corrections.
Preoperatively, higher OSPRO-YF total score was associated with greater concurrent PROMIS-CAT Pain Interference (r = 0.43; < .01) and Depression (r = 0.36; = .05) and lower ASES (r = -0.34; < .01). Higher postoperative OSPRO-YF was also associated with greater concurrent PROMIS-CAT Pain Interference (r = 0.43; < .01) and Depression (r = 0.36; < .01) and lower ASES (r = -0.34; = .01). ASES had strong correlation with Single Assessment Numeric Evaluation and Pain scores at both preoperative and postoperative timepoints. Single Assessment Numeric Evaluation was not significantly associated with OSPRO-YF total score or number of yellow flags at either timepoints.
The study findings support the clinical validity of the 10-item OSPRO-YF tool when administered before or after shoulder surgery. For patients exhibiting suboptimal recovery or those identified as high risk at initial screening, assessment of pain-related psychological distress postoperatively may be particularly beneficial in guiding rehabilitation.
用于预测转诊及结局的黄旗优化筛查（OSPRO - YF）工具是一种包含10个条目的多维筛查工具，用于评估患有肌肉骨骼疼痛疾病个体的疼痛相关心理特征。术后收集的OSPRO - YF的有效性尚不清楚。本研究旨在通过在术前和术后环境中将其与患者报告的结局评分进行比较，评估OSPRO - YF的有效性。
作者假设OSPRO - YF总分在术前和术后时间点与肩部及整体功能的患者报告结局（PROs）相关。
对一家大型学术机构的一位运动医学骨科医生进行的101例肩部手术患者进行了回顾性研究。90例和54例患者分别有完整的术前和术后患者报告结局反应。在资深作者的门诊中，术前和术后常规使用OSPRO - YF、美国肩肘外科医生（ASES）评估表以及患者报告结局测量信息系统计算机自适应测试（PROMIS - CAT）。通过使用Pearson相关性和多重比较校正将OSPRO - YF在任一时刻的分数与PROs进行横断面比较，评估其同时效度。
术前，较高的OSPRO - YF总分与较高的同时期PROMIS - CAT疼痛干扰（r = 0.43；P <.01）和抑郁（r = 0.36；P =.05）以及较低的ASES（r = -0.34；P <.01）相关。术后较高的OSPRO - YF也与较高的同时期PROMIS - CAT疼痛干扰（r = 0.43；P <.01）和抑郁（r = 0.36；P <.01）以及较低的ASES（r = -0.34；P =.01）相关。ASES在术前和术后时间点与单项评估数字评价及疼痛评分均有很强的相关性。单项评估数字评价在任一时刻与OSPRO - YF总分或黄旗数量均无显著相关性。
研究结果支持在肩部手术前或后使用包含10个条目的OSPRO - YF工具的临床有效性。对于恢复欠佳或在初始筛查中被确定为高风险的患者，术后评估疼痛相关的心理困扰可能对指导康复特别有益。
