Revisiting classification of pain from bone metastases as mild, moderate, or severe based on correlation with function and quality of life

Abstract

Purpose The objective of our study was to determine the optimal cut points for classification of pain scores as mild, moderate, and severe based on interference with function and quality of life (QOL). Methods We evaluated 822 patients who completed the Brief Pain Inventory (BPI) and/or the European Organization for Research and Treatment of Cancer (EORTC) QOL Questionnaire Core 30 (QLQ-C30) prior to receiving repeat radiation therapy for previously irradiated painful bone metastases. Optimal cut points for mild, moderate, and severe pain were determined by the MANOVA that yielded the largest F ratio for the between category effect on the seven interference items of BPI and the six functional domains of QOL (physical, role, emotional, cognitive, social functioning, and global QOL) as indicated by Pillai's Trace, Wilk's λ, and Hostelling's Trace F statistics. Results For BPI and for QOL domains separately, the two largest F ratios for Wilk's λ, Pillai's Trace, and Hotelling's Trace F statistics were from the cut points 4, 8 and 6, 8. When combining both, the optimal cut points were 4, 8 with 1-4 (mild), 5-8 (moderate), and 9-10 (severe). With this classification, the mean scores of all the seven interference items in BPI and the six functional domains were all highly statistically Electronic supplementary material The online version of this article

Shortness of breath on day 1 after surgery alerting the presence of postoperative pulmonary complications in patients with lung cancer

“…Investigations have also used anchor-based methods to describe grades of symptom severity as the basis for establishing cutpoints between mild, moderate, and severe levels for various symptoms [43].…”

Efficacy of percutaneous vertebroplasty for the relief of osteoblastic spinal metastasis pain

“…Pain scores are classified as follows: VAS 1-4, mild pain; 5-8, moderate pain; and 9-10 as severe pain ( 43 ). Previous studies of osteoblastic spinal metastases showed postoperative pain relief.…”

Profiling Arthritis Pain with a Decision Tree

“…Individuals answered the 12‐Item Short Form (SF‐12) questionnaire item “pain limits normal work” ([1] not at all [ n = 1,328], [2] a little bit [ n = 1,579], [3] moderately [ n = 1,097], [4] quite a bit [ n = 1,184], and [5] extremely [ n = 533]). Based on research relating pain levels to quality of life, a 3‐category model provided good discriminative fit (1 to 2 as mild, 3 to 4 as moderate, and 5 as severe). We further collapsed the response categories into dichotomous coding to reduce the false‐positive rate and to maximize the ability to distinguish low‐ or no‐pain conditions from pain‐related reports.…”