日本語版Optimal Screening for Prediction of Referral and Outcome Yellow Flag Assessment Toolの作成―その信頼性と妥当性の検討―

Introduction: In recent years, it has been reported that psychosocial factors of patients with orthopedic disorders are involved in pain chronicity. Thus, it is effective to attend to psychosocial aspects as early as possible. The “Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF)” assessment tool collects patient-reported outcomes for 17 items, which can comprehensively evaluate multiple psychological factors. We developed the Japanese version of OSPROYF (OSPRO-YF-J) and verified its reliability and validity. Methods: First, after obtaining permission to develop the Japanese version, we translated OSPRO-YF according to international guidelines. In the preliminary analysis (n = 21; average age, 49.1±20.4 years; 5 males and 16 females), we evaluated the cross-cultural understanding of item expressions and time required to complete the questionnaire. In addition, we verified its reliability. We statistically analyzed reliability in terms of reproducibility, internal consistency, and absolute reliability. We then verified the external validity of OSPRO-YF-J in a separate sample (n = 251; average age, 65.3±13.4 years; 70 males and 181 females). We summarized the obtained data descriptively and confirmed the presence of the ceiling and floor effects. Results: The average time required to complete OSPRO-YF-J was 4.4±2.4 minutes, and the average score was 36.6±10.3 points. No ceiling or floor effect was observed. For reproducibility (Intraclass correlation coefficient = 0.86), Cronbach’s α was 0.84, correlation coefficients for each item ranged from 0.4 to 0.7. Furthermore, in Bland-Altman analysis, no systematic errors (fixed or proportional errors) but only accidental errors were recognized in OSPRO-YF-J. Conclusions: OSPRO-YF-J was confirmed to show good reliability and validity. OSPRO-YF-J is a comprehensive psychological evaluation scale and can be easily implemented in the clinical setting. Therefore, we think that it is a practical questionnaire for evaluating psychological factors.