AB1399-HPR Concurrent validity and stability of subgroup assignment to three levels of pain condition severity in patients with musculoskeletal pain
Authors: C Emilson, I. Demmelmaier, S. Bergman, S. Pettersson, P. Åsenlöf
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Pain screening instruments have been used to identify risk factors for poor prognosis and are recommended for the stratification of treatment for musculoskeletal pain. <h3>Objectives</h3> The aim of this study was to investigate the concurrent validity of subgroup assignment based on the Örebro Musculoskeletal Pain Screening Questionnaire compared with reference instruments: The Pain Disability Index, the Tampa Scale for Kinesiophobia, and the Pain Catastrophizing Scale. A secondary aim was to investigate the stability of the subgroup assignment over a defined period of time. <h3>Methods</h3> Participants (n=40) aged 18–65 years were recruited from five primary health care centres in Sweden. Data were collected using self-reported questionnaires. The subgroups based on the Örebro Musculoskeletal Pain Screening Questionnaire were pre-defined to low, moderate or high pain condition severity. The reference instrument data were dichotomized into low or high level based on previously used cut-off scores. Concurrent validity was analysed with Fisher's exact test. Stability was calculated using quadratic-weighted kappa analysis. <h3>Results</h3> The results indicated acceptable psychometric properties of the subgroup assignment based on the Örebro Musculoskeletal Pain Screening Questionnaire regarding concurrent validity, and the stability (<i>K</i><sub>w</sub>:0.51, 95% CI: 0.22–0.81) over two to three weeks. To further increase validity, it is suggested that subgroup assignment is complemented with other measures assessing e.g. pain catastrophizing. <h3>Conclusions</h3> In conclusion, assignment to subgroups with low, moderate and high levels of pain condition severity based on the Örebro Musculoskeletal Pain Screening Questionnaire, could be used as a valid basis for stratified treatment for patients with musculoskeletal pain. <h3>References</h3> [1] Linton SJ, Boersma K. Early identification of patients at risk of developing a persistent back problem: the predictive validity of the Orebro Musculoskeletal Pain Questionnaire. The Clinical journal of pain. 2003;19(2):80–86. [2] Hill JC, Dunn KM, Main CJ, Hay EM. Subgrouping low back pain: a comparison of the STarT Back Tool with the Orebro Musculoskeletal Pain Screening Questionnaire. European journal of pain. 2010;14(1):83–89. [3] Soer R, Koke AJ, Vroomen PC, et al. Extensive validation of the pain disability index in 3 groups of patients with musculoskeletal pain. Spine. 2013;38(9):E562–568. [4] Lundberg MKE, Styf J, Carlsson SG. A psychometric evaluation of the Tampa Scale for Kinesiophobia — from a physiotherapeutic perspective. Physiotherapy theory and practice. 2004;20(2):121–133. [5] Sullivan MJL, Bishop SR, Pivik J. The Pain Catastrophizing Scale: Development and validation. Psychological Assessment. 1995;7(4):524–532. <h3>Acknowledgements</h3> The study received financial support from the Swedish Rheumatism Association, Uppsala County Council, and Caring Sciences Funding at the Faculty of Medicine, Uppsala University. <h3>Disclosure of Interest</h3> None declared