Italian versions of the optimal screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) and the Örebro Musculoskeletal pain screening questionnaire (ÖMPQ-21) and their short forms, in patients with low back pain: Cross-cultural adaptation, reliability and validity

Background

Low back pain (LBP) is a leading cause of disability worldwide. Early detection of prognostic factors using the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) or the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPQ-21) can predict improvement in pain and disability for patients with nonspecific LBP.

Objectives

To translate and cross-culturally adapt the OSPRO-YF and the ÖMPQ-21 with their short versions into the Italian language and to test their measurement properties in patients with LBP.

Design

Clinimetric study.

Methods

OSPRO-YF and ÖMPQ-21 were translated and administered to LBP patients with questionnaires on pain intensity, disability, pain self-efficacy, and pain catastrophizing. We evaluated test-retest reliability, measurement error, and construct validity.

Results

Eighty-three patients with LBP were included. No floor or ceiling effects were reported. Test-retest reliability of the OSPRO-YF, the ÖMPQ-21, and their short forms were excellent. The measurement error analysis revealed a Standard Error of Measurement (SEM) of 6.7 points, a Minimal Detectable Change (MDC) of 18.6 points for ÖMPQ-21, a SEM of 2.3 points, and a MDC of 6.4 points for OSPRO-YF. The construct validity of the OSPRO-YF and ÖMPQ-21 and its 10-item short version was satisfactory and moderate. OSPRO-YF performed better than ÖMPQ-21 on all three measurement properties.

Conclusion

OSPRO-YF, ÖMPQ-21, and their short versions are reliable and valid for identifying ‘yellow flags’ in Italian patients with LBP, with the former generally performing better than the latter. Further research is needed to confirm their ability to predict outcomes in patients with LBP.