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Grading the intensity of nondental orofacial pain: Identification of cutoff points for mild, moderate, and severe pain

Brailo, V; Zakrzewska, JM; (2015) Grading the intensity of nondental orofacial pain: Identification of cutoff points for mild, moderate, and severe pain. Journal of Pain Research , 8 95 - 104. 10.2147/JPR.S75192. Green open access

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Abstract

Background: When assessing pain in clinical practice, clinicians often label pain as mild, moderate, and severe. However, these categories are not distinctly defined, and are often used arbitrarily. Instruments for pain assessment use more sophisticated scales, such as a 0–10 numerical rating scale, and apart from pain intensity assess pain-related interference and disability. The aim of the study was to identify cutoff points for mild, moderate, and severe nondental orofacial pain using a numerical rating scale, a pain-related interference scale, and a disability measurement. Materials and methods: A total of 245 patients referred to the Facial Pain Unit in London were included in the study. Intensity and pain-related interference were assessed by the Brief Pain Inventory. Pain-related disability was assessed by the Chronic Graded Pain Scale. Average pain intensity (0–10) was classified into nine schemes with varying cutoff points of mild, moderate, and severe pain. The scheme with the most significant intergroup difference, expressed by multivariate analysis of variance, provided the cutoffs between mild, moderate, and severe pain. Results: The combination that showed the greatest intergroup differences for all patients was scheme 47 (mild 1–4, moderate 5–7, severe 8–10). The same combination provided the greatest intergroup differences in subgroups of patients with temporomandibular disorder and chronic idiopathic facial pain, respectively. Among the trigeminal neuralgia patients alone, the combination with the highest intergroup differences was scheme 48 (mild 1–4, moderate 5–8, severe 9–10). Conclusion: The cutoff points established in this study can discriminate in pain intensity categories reasonably well, and showed a significant difference in most of the outcome measures used.

Type: Article
Title: Grading the intensity of nondental orofacial pain: Identification of cutoff points for mild, moderate, and severe pain
Open access status: An open access version is available from UCL Discovery
DOI: 10.2147/JPR.S75192
Publisher version: http://dx.doi.org/10.2147/JPR.S75192
Additional information: Copyright © 2015 Brailo and Zakrzewska. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License
Keywords: Chronic orofacial pain, cutoff point, trigeminal neuralgia, temporomandibular disorder.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
URI: https://discovery.ucl.ac.uk/id/eprint/1462581
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