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Exploring Established Cut-Off Points for Pain Levels in the Numeric Rating Scale: Insights From a Literature
Aurora Monticelli1, Bastiaan Van Grootven2
1Public Health Department, Nursing Science, University of Basel, Basel, Switzerland.
Summary
Pain assessment using the Numeric Rating Scale (NRS) lacks consensus on cut-off points for mild, moderate, and severe pain. This variability highlights the need to reassess current pain management guidelines and quality monitoring practices.
Area of Science:
- Medical Research
- Pain Management
- Clinical Assessment
Background:
- Numerical Rating Scales (NRS) are standard for measuring pain in healthcare settings.
- Established cut-off points for pain intensity are used in clinical practice for management and quality monitoring.
- A clearer understanding of these pain thresholds is needed.
Purpose of the Study:
- To identify and synthesize cut-off points for different pain intensities on the Numeric Rating Scale from existing literature.
- To analyze the variability and consistency of these identified thresholds across studies.
Main Methods:
- A comprehensive literature review was conducted.
- Searches were performed in PubMed, Embase, and Google Scholar.
- Included studies were screened using Rayyan, with data extracted and synthesized.
Main Results:
- Twenty-one papers were included, revealing wide variations in NRS cut-off points for pain intensity.
- Mild pain ranges (0-5, most cited 1-4), moderate pain (3-8, most cited 4-8), and severe pain (5-10, most cited 7-10) showed little consistency.
- A lack of consensus persists regarding single versus overlapping cut-off points.
Conclusions:
- Establishing definitive NRS pain cut-off values is challenging due to inconsistent literature.
- Variability is attributed to differences in populations, pain types, and methodologies.
- Reassessment of pain assessment guidelines and quality monitoring policies relying on NRS cut-offs is crucial, alongside exploring alternative tools.
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