Table 3.
Published studies about optimal cut-off point schemes for mild, moderate, and severe pain in terms of interference with functioning.
| Study, authors | Type of pain/diagnosis | Pain measurement | n | Optimal cut-off points found in the study | Range of values studied by the authors for the lower cut-off point (between mild and moderate), and the higher cut-off point (between moderate and severe) | |
|---|---|---|---|---|---|---|
| Lower | Higher | |||||
| Serlin et al., 1995 | Cancer pain | NRS, worst pain | 470 | 4 | 6 | Lower cut-off point: 3–4 |
| Higher cut-off point: 6–7 | ||||||
| Jensen et al., 1999 | Leg amputation patients: | NRS, average pain | ||||
| Phantom pain | 74 | 4 | 7 | Lower cut-off point: 3–4 | ||
| Back pain | 29 | 4 | 6 | Higher cut-off point: 6–7 | ||
| General pain | 102 | 3 | 6 | |||
| Zelman et al., 2003 | Low back pain | NRS, average pain | 96 | 5 | 8 | Lower cut-off point: 4–6 |
| Osteoarthritis | 98 | 5 | 7 | Higher cut-off point: 6–8 | ||
| Turner et al., 2004 | CTS | NRS, average pain | No superior | Lower cut-off point: 3–5 | ||
| Low back injuries | scheme | 6 | Higher cut-off point: 6–7 | |||
| 4 | ||||||
| Zelman et al., 2005 | Diabetic peripheral neuropathy | NRS, worst and average pain | 255 | 4 | 7 | Lower cut-off point: 4–6 |
| Higher cut-off point: 6–8 | ||||||
| Paul et al., 2005 | Cancer pain | NRS, average pain | 160 | 4 | 7 | Lower cut-off point: 3–5 |
| Higher cut-off point: 5–7 | ||||||
| Fejer et al., 2005 | Neck pain | NRS, average, worst, and characteristic pain | 1385 | 4 | 7 | 14 categories between 3 and 8 |
| Hanley et al., 2006 | Spinal cord injury | NRS, (a) overall pain or (b) current pain at worst location | a: 307 b: 174 | a and b: 3 | a: 7 | Lower cut-off point: 3–4 |
| b: 6 | Higher cut-off point: 6–7 | |||||
| Li et al., 2007 | Cancer pain, patients with bone metastases | NRS, (a) worst, (b) average, and (c) current | 199 | a and b: 4, c: 2 | a, b, and c: 6 | Lower cut-off point: 2–8 |
| Higher cut-off point: 3–9 | ||||||
| Kapstad et al., 2008 | Osteoarthritis of the hip | NRS, average pain | 224 | 4 | 6 | Lower cut-off point: 3–5 |
| Osteoarthritis of the knee | 94 | 4 | 7 | Higher cut-off point: 5–7 | ||
| Kalyadina et al., 2008 | Cancer pain, hematological malignancies or solid tumors | NRS, worst pain | 221 | 4 | 6 | Lower cut-off point: 3–4 |
| Higher cut-off point: 6–7 | ||||||
| Ferreira et al., 2011 | Cancer pain | NRS, worst pain | 143 | 4 | 7 | Lower cut-off point: 3–5 |
| Higher cut-off point: 5–7 | ||||||
| Hoffman et al., 2010 | Diabetic peripheral neuropathy | NRS, average pain | 401 | 3 | 6 | Not mentioned |
| Hirschfeld and Zernikow, 2013 | Children and adolescents with chronic pain | NRS, maximum pain | Lower cut-off point: 2–7 | |||
| Higher cut-off point: 3–8 | ||||||
| Whole sample | 2249 | 4 | 8 | |||
| Constant pain | 650 | 5 | 8 | |||
| Chronic headache | 430 | 4 | 8 | |||
| Musculoskeletal pain | 295 | 2 | 8 | |||
| Boonstra et al., 2014 | Musculoskeletal pain | VAS, average pain | 456 | 3 | 6 | Lower cut-off point: 3–5 |
| Higher cut-off point: 5–7 | ||||||
| Brailo and Zakrzewska, 2015 | Nondental orofacial pain | NRS, average pain | 245 | 4 | 7 | Lower cut-off point: 3–5 |
| Higher cut-off point: 5–9 | ||||||
| Present study | Musculoskeletal pain | NRS, average pain | 2854 | 5 | 7 | Lower cut-off point: 2–8 |
| Higher cut-off point: 3–9 | ||||||
Cut-off points (CP): figures refer to highest scores in the first and second categories, for example CP lower 4, higher 7 means: first category includes the NRS scores 1–4, second category NRS 5–7, third category NRS 8–10.
NRS: numeric rating scale; VAS: visual analog scale.