text: Discussion 
  This study identified novel predictors for pain-related 
  utilization outcomes following an episode of physical 
  therapy for a primary complaint of musculoskeletal 
  pain. The most robust 
  finding from these analyses 
  was that baseline disability and change in pain inten- 
  sity over the first 4 weeks following physical therapy 
  evaluation were consistent predictors of subsequent 
  pain-related healthcare utilization in those participants 
  that completed all follow up. Aside from these robust 
  predictors, other individual predictors of utilization 
  were highly outcome-specific. High model specificity 
  for utilization outcomes observed in this study is con- 
  sistent with a recent systematic review that 
  found 
  similar levels of model specificity for more traditional 
  outcomes 
  like pain intensity, disability and work 
  absenteeism [14]. Across models, health-related vari- 
  ables were generally stronger predictors than sociode- 
  mographic factors, which is also supported by prior 
  research [15, 16]. Additionally, there were cases when 
  prediction models were improved for specific services 
  (e.g. surgery, use of opioids) when considering change 
  in pain, disability or pain-related psychological dis- 
  tress. A notable finding is that the OSPRO-YF had 
  the greatest utility when used to measure change in 
  pain-related psychological distress. Current risk pre- 
  diction paradigms in musculoskeletal pain consider 
  only baseline pain-related psychological distress. How- 
  these results underscore the importance of 
  ever, 