The Best-Worst Scale in Non-Oncologic Lower Limb Pain

Non-oncologic lower limb pain is a complex condition that influences patients' quality of life and is challenging to manage due to its multifactorial nature. Traditional pain assessment methods focus on intensity, overlooking broader patient experiences. The Best-Worst Scale (BWS) is an approach that is increasingly used in healthcare, particularly in understanding patient preferences. The aim of this study is to map the existing research, identify key concepts, evidence types, and gaps in the literature on the management and implications of non-oncologic lower limb pain with the goal of enhancing patients' quality of life using BWS methodology. A narrative review was performed and conducted between October and November 2024, in PubMed and the Revista Portuguesa de Medicina Geral e Familiar. The search strategy focused on chronic non-oncologic pain of the lower limb and another one on BWS and its application to the topic under study. From 124 articles, 16 were included. Regarding BWS, the studies describe it as a promising tool for improving healthcare research, highlighting its various applications, advantages, and limitations. They address the main concerns of osteoarthritis patients and their preferences regarding available treatments. Integrating BWS into clinical practice can lead to improved perception of pain assessment and greater patient satisfaction, shaping the treatment strategy based on patient preferences. The analysis suggests that BWS is a superior approach to other forms of assessing non-oncologic pain in the lower limbs. It may allow us to identify a mismatch between the goals of clinicians and the patient's goals. Best-worst scales to be used in this area must be carefully adjusted when in general application, and their validity and effectiveness thoroughly evaluated. Future research should focus on the implementation and development of BWS in holistic approaches, ensuring both patient-centered and evidence-based treatment. Bridging these gaps will contribute to an improvement in the quality of life of individuals suffering from non-oncologic pain in the lower limbs.