Numeric Pain Rating Scale
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Purpose[edit | edit source]
The Numeric Pain Rating Scale (NPRS) is a unidimensional measure of pain intensity in adults,Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title including those with chronic pain due to rheumatic diseases.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Content[edit | edit source]
The NPRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0–10 integers) that best reflects the intensity of his/her pain.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title The common format is a horizontal bar or line. Similar to the VAS, the NPRS is anchored by terms describing pain severity extremes.[1]
Number of Items[edit | edit source]
Although various iterations exist, the most commonly used is the 11-item NPRS.[2]
Response Options/Scale[edit | edit source]
The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. “no pain”) to '10' representing the other pain extreme (e.g. “pain as bad as you can imagine” or “worst pain imaginable”).Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Recall Period for Items[edit | edit source]
Recal varies, but respondents are most commonly asked to report pain intensity “in the last 24 hours” or an average pain intensity.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Obtaining the Scale[edit | edit source]
Available from Partners Against Pain.
Administration[edit | edit source]
The NPRS can be administered verbally (therefore also by telephone) or graphically for self-completion.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title As mentioned above, the respondent is asked to indicate the numeric value on the segmented scale that best describes their pain intensity.[1]
Scoring and Interpretation[edit | edit source]
Scores range from 0-10 points, with higher scores indicating greater pain intensity.[1]
Merits and Demerits[edit | edit source]
- The NPRS takes <1 minute to complete
- The NPRS is easy to administer and scoreCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid<ref>tag; name cannot be a simple integer. Use a descriptive title - Minimal language translation difficulties supports the use of the NPRS across cultures and languagesCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title - The NPRS is a valid and reliable scale to measure pain intensit [1]
- Strengths of this measure over the VAS are the ability to be administered both verballyand in writing, as well as its simplicity of scoring[1]
- One weakness is that the NPRS evaluates only 1 component of the pain experience and intensity, and therefore does not capture the complexity and idiosyncratic nature of the pain experience or improvements due to symptom fluctuations.
Psychometric Information[edit | edit source]
Development[edit | edit source]
To improve discrimination for detecting relatively small changes, an NPRS comprised of numbers along a scale was used in a population of 100 patients with a variety of rheumatic diseases. Variations in pain descriptors used as anchors for end points on the NPRS have been reported in the literature. However, the methodology used to develop these various anchor terms is unknown.[3][4]
Acceptability[edit | edit source]
Chronic pain patients prefer the NPRS over other measures of pain intensity, including the VAS, due to comprehensibility and ease of completion.[5] However, focus groups of patients with chronic back pain and symptomatic hip and knee osteoarthritis (OA) have found that the NPRS is inadequate in capturing the complexity and idiosyncratic nature of the pain experience or improvements due to symptom fluctuations.[6][7]
Reliability[edit | edit source]
High test–retest reliability has been observed in both literate and illiterate patients with rheumatoid arthritis (r = 0.96 and 0.95, respectively) before and after medical consultation.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Validity[edit | edit source]
For construct validity, the NPRS was shown to be highly correlated with the VAS in patients with rheumatic and other chronic pain conditions (pain>6 months): correlations range from 0.86 to 0.95.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Minimal Clinically Important Difference (MCID)[edit | edit source]
In clinical trials of pregabalin (also known as Lyrica) for diabetic neuropathy, postherpetic neuralgia, chronic low back pain, fibromyalgia, and OA, analyses of the relationships between changes in NPRS scores and patient reports of overall improvement (measured using a standard 7-point patient Global Impression of Change), demonstrated a reduction of 2 points, or 30%, on the NPRS scores to be clinically important.[8] Similar results were found in low back pain patients when changes in NPRS scores were compared to patient improvements in pain after physical therapy using a 15-point Global Rating of Change scale.[9] In another study, the MCID was found to be 2 points in patients with shoulder pain.[10]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 HAWKER GA. Measures of Adult Pain. Arthritis Care & Research 2011; 63,S240–S252
- ↑ Williamson A. Pain: a review of three commonly used pain rating scales. ISSUES IN CLINICAL NURSING 2005; 14: 798–804
- ↑ Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA, Anderson JA. Studies with pain rating scales. Ann Rheum Dis 1978;37:378–81.
- ↑ Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain 1986;27:117–26.
- ↑ De C Williams AC, Davies HT, Chadury Y. Simple pain rating scales hide complex idiosyncratic meanings. Pain 2000;85:457–63
- ↑ Hawker GA, Davis AM, French MR, Cibere J, Jordan JM, March L, et al. Development and preliminary psychometric testing of a new OA pain measure: an OARSI/OMERACT initiative. Osteoarthritis Cartilage 2008;16:409–14
- ↑ Hush JM, Refshauge KM, Sullivan G, De Souza L, McAuley JH. Do numerical rating scales and the Roland-Morris Disability Question-naire capture changes that are meaningful to patients with persistent back pain? Clin Rehabil 2010;24:648–57.
- ↑ Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 2001;94:149–58.
- ↑ Childs JD, Piva SR, Fritz JM. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine 2005;30:1331–4
- ↑ Michener LA, Snyder AR, Leggin BG. Responsiveness of the numeric pain rating scale in patients with shoulder pain and the effect of surgical status. Journal of sport rehabilitation. 2011 Feb 1;20(1):115.
