Passing a parameter by reference, which is what happens when you use the ``out`` or ``ref`` parameter modifiers, means that the method will receive a pointer to the argument, rather than the argument itself. If the argument was a value type, the method will be able to change the argument's values. If it was a reference type, then the method receives a pointer to a pointer, which is usually not what was intended. Even when it is what was intended, this is the sort of thing that's difficult to get right, and should be used with caution.
This rule raises an issue when ``out`` or ``ref`` is used on a non-``Optional`` parameter in a public method. ``Optional`` parameters are covered by S3447.