The Screening for Pain Vulnerability And REsilience (SPARE) tools were developed in collaboration with Focus on Therapeutic Outcomes (FOTO) to measure 3 broad psychological domains: fear avoidance, negative mood, and positive coping. Although developed as 3 separate tools, they are designed to be used together to assess a broad spectrum of general and pain related psychological factors known to impact outcomes for people with musculoskeletal conditions. They can be used in a variety of care settings where patients with musculoskeletal conditions are treated including primary care, physical therapy, and orthopedics.
How were they developed?
The SPARE tools were developed using existing psychological measures that were combined and analyzed with item response theory (IRT) methods. IRT methods are useful because they help create more accurate measures of a characteristic. The method reduce bias in questions, ensuring measures are appropriate for people with all levels of psychological distress. IRT also allows for adaptive testing, where the test changes its difficulty based on your answers, making it more efficient and effective. These are the same methods used to develop SATs and PROMIS measures.
How do SPARE measures differ from other common psychological measures?
Most other mental health and psychological questionnaires were developed using Classical Test Theory (CTT). CTT assumes that every question on the questionnaire contributes equally to the overall score, making it simpler and easier to understand. However, the results can vary depending on the group of people completing the questionnaire. On the other hand, IRT looks at each question individually, considering its difficulty (or the intensity of distress it represents) and how likely a person with a certain level of distress is to answer it correctly. This method uses complex mathematical models, making it more accurate and consistent across different groups of people. While CTT assumes random errors and focuses on the overall score, IRT provides detailed information about errors and better estimates a person’s true level of psychological distress. In summary, CTT is like looking at the overall performance on the questionnaire, while IRT focuses on each question’s difficulty and measurement accuracy.
Why are there different versions and which one should I use?
Currently, SPARE tools are available in 4-item short forms (12 items total for all 3 domains) and CATs. Use of CATs requires specialized software and programming knowledge to integrate the tools. Most clinical applications involve the 4-item short forms. These are easy and efficient options that have high levels of precision and reliability. They are also relatively simple to score.
