What is the gold standard for screening for yellow flags?

[dogrady22]

Hi everyone...

Would anybody happen to know what the gold standard questionnaire is for screening for yellow flags for people at risk of chronic pain?

Cheers for any thoughts

Dan

[Jason Silvernail]

Hi dogrady.

I don't believe there is one gold standard, but the Fear Avoidance Beliefs questionnaire is probably the most common and most frequently cited in research.
Here is the FABQ, another scale that might be helpful, and a few articles on the use of the FABQ.

Hope they're helpful.

[nari]

The FABQ is used most frequently, and TAMPA probably around second place.
I found it interesting that if used only a few times during an attendance over 6-8 weeks for complex pain patients, it doesn't help much. Like blood pressure, the answers fluctuated quite significantly depending on the context. I don't know how well this has been studied, but all of the scales show only a tendency towards improvement or deterioration.
I also found the answers sometimes did not match presentation; an anxious and sad person often scored well over a period of several questionnaires, and vice versa.
The psychologists accepted this variability. Probably that is why there is no gold standard; three or four different questionnaires may be more accurate, but quite overwhelming for the patient!

Nari

[Luke Rickards]

Nari,

I have found throughout my research that this variablity is common. Sometimes within a few minutes a patient will report a pain intensity of 8 or more on the VAS, yet rate their pain as mild in section 1 of the NDI or ROPQ.

[nari]

The psychs don't take much notice of pain scales. When they all add up consistently, they do. Otherwise, they are mostly ignored.

The recording of a physiological state seems more subjective than objective. Rather like a friend of mine whose BP registered high each time she went to the doc, and he wanted her to take antihypertensive meds. So she bought a monitor, and her everyday BP came in on 110/60-70 over 2 weeks......if she had accepted his recommendation, she would have fallen over or worse by now. There's a moral there somewhere.

Nari