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The Brief Pain Inventory
User Guide
Charles S. Cleeland, PhD
ii
Copyright and Terms of Use
The Brief Pain Inventory (BPI) copyright is held by
Dr. Charles S. Cleeland (1991). The copyright
applies to the BPI and all its derivatives in any
language.
The BPI may not be used or reproduced without
permission from Charles S. Cleeland, PhD, or his
designee. Fees for use may apply.
The BPI may not be modified or translated into
another language without the express written
consent of the copyright holder. Failure to
comply may result in legal action. Permission to
alter or translate the instrument may be obtained
by contacting Dr. Charles S. Cleeland either by
e-mail at symptomresearch@mdanderson.org or
by mail at:
Charles S. Cleeland, PhD
Professor and Chair, Department of
Symptom Research
The University of Texas M. D. Anderson
Cancer Center
1515 Holcombe Boulevard, Unit 1450
Houston, Texas 77030
Visit www.mdanderson.org/departments/prg >
Assessment Tools > Brief Pain Inventory for more
information.
© 2009 Charles S. Cleeland
All rights reserved
i
Table of Contents
Chapter 1................................................................. 1
Development of the Brief Pain Inventory ..............1
Background........................................................ 1
Developing a Measurement Model and Items 2
Test Construction Standards......................... 3
Measurement Conceptualization: Multiple
Dimensions of Pain........................................ 3
Early Version: The Wisconsin Brief Pain
Questionnaire..................................................... 5
The Brief Pain Inventory...................................... 6
Scoring the Brief Pain Inventory as an
Outcome Measure....................................... 7
Psychometric Properties of the Brief Pain
Inventory........................................................ 8
References........................................................11
Chapter 2................................................................15
BPI References: Use of the BPI in Various Studies 15
Cancer Bone Pain.............................................16
Cancer Epidemiology ......................................20
Cancer Pain......................................................21
Depressive Disorders.........................................31
Fabry Disease....................................................32
Fibromyalgia......................................................33
HIV/AIDS ............................................................34
Minority Studies..................................................35
Neuromuscular Pain..........................................36
Neuropathic Pain..............................................40
Osteoarthritis and Other Joint Diseases...........42
Psychosocial Studies.........................................45
Surgical and Procedural Pain...........................46
Validation Studies.............................................49
Language Translations......................................58
Methods Papers................................................59
ii
1
Chapter 1
Development of the Brief Pain
Inventory
The Brief Pain Inventory (BPI) has become one of
the most widely used measurement tools for
assessing clinical pain. The BPI allows patients to
rate the severity of their pain and the degree to
which their pain interferes with common
dimensions of feeling and function. Initially
developed to assess pain related to cancer, the
BPI has been shown to be an appropriate
measure for pain caused by a wide range of
clinical conditions. The BPI has been used in
hundreds of studies. In some ways, the BPI is a
legacy instrument— a self-report measure that
has, over time, become a standard for the
assessment of pain and its impact.
Background
In the late 1970s, it became increasingly evident
that patients with cancer, especially the later
stages of the disease, experienced
incapacitating pain that was often poorly
controlled. A constellation of events— the
publishing of opinion pieces by prominent
persons with cancer pain, the increasing
advocacy of pain professionals and
organizations for better cancer pain
management, a growing awareness of the
problem by national and international policy
groups, and the simple recognition that pain
often could be controlled—created the climate
for a sustained effort to improve pain
management for those with cancer.
2
A first step in this effort was to document the extent of poor pain
management. The National Cancer Institute (NCI) and the Cancer
Unit of the World Health Organization (WHO) wanted
measurement instruments that would better capture the severity
and impact of cancer pain and measure improvement in pain
after changes in analgesic practice or implementation of new
pain treatments. These instruments also needed to function well in
large-scale national and international studies of the epidemiology
of cancer pain.
With grant support from both the NCI and the WHO, the Pain
Research Group at the University of Wisconsin Medical School-
Madison, under the direction of Charles S. Cleeland, PhD,
undertook a program to test and develop self-report measures of
cancer pain and to apply them to studies of pain and its
treatment in the United States and internationally. The Pain
Research Group, now the Department of Symptom Research at
The University of Texas M. D. Anderson Cancer Center, was also the
WHO Collaborating Center for Symptom Research in Cancer.
Developing a Measurement Model and Items
Several existing pain measures (such as the McGill Pain
Questionnaire; Melzack, 1975) were field-tested in interviews with
cancer patients who had pain (N=50). Almost all of these
measures had been designed to assess pain in patients with
nonmalignant disease. The patients reported that the measures
were too complex and too long, making them excessively
burdensome for patients with high levels of pain. Patients also
noted that the existing instruments included items not relevant to
cancer patients and sometimes required responses that patients
felt were ambiguous (Cleeland, 1984). Patients were also asked
what questions they felt were the most important for
communicating their experience of pain. The results of this study
made clear that a new measurement instrument was needed.
The Pain Research Group planned a program to develop such an
instrument. The aims were to have a scale that: (a) would take
only a short time to complete; (b) would be easy for patients to
understand; (c) could be self-administered for literate patients, or
be completed by interview for illiterate or low-literacy patients; (d)
3
would be easily translated for non-English-speaking patients; and
(e) would capture not only pain severity, but also the perception
of how pain interfered with daily life.
Test Construction Standards
As a guide to scale construction, we used then-current
psychometric standards found in the Standards for Educational
and Psychological Tests published by the American Psychological
Association, American Educational Research Association, and the
National Council on Measurement in Education (1974). These
standards included common elements of test validity (content,
criterion, and construct) and reliability (internal consistency and
test-retest). These standards had not been systematically applied
in the development of the existing pain report scales.
Measurement Conceptualization: Multiple Dimensions of Pain
That pain is multidimensional was made clear during our patient
interviews: patients reported that an adequate representation of
pain required more than one simple measure of pain intensity.
Melzack and Casey (1968) suggested that, based on the
underlying neurophysiological mechanisms of pain, pain
assessment should include three dimensions: sensory-
discriminative, motivational-affective, and cognitive-evaluative.
This approach to self-report measurement relied on three distinct
patterns of responses to the words that patients used to describe
their pain. However, the patients we interviewed had difficulty
discriminating between the motivational-affective and cognitive-
evaluative dimensions (Cleeland, 1989; Cleeland, 1990).
More commonly, researchers have found that two dimensions of
pain self-report account for most of the variability in the way
patients describe pain. Beecher (1959) called these dimensions
pain and “reaction to pain; Clark and Yang (1983) called them
sensory-discriminative” and “attitudinal. Following Beecher, we
called these dimensions “sensory” and “reactive” (Cleeland,
1989).
Accordingly, our new questionnaire was developed to include
items that reported the sensory” dimension of pain (intensity, or
severity) and the “reactive” dimension of pain (interference with
4
daily function). We constructed four items to capture the variability
of pain over time: pain at its “worst,”least,”average,” and
now” (current pain). On the basis of patient interviews from
additional field testing, we chose seven items that measured how
much pain interfered with various daily activities, including general
activity, walking, work, mood, enjoyment of life, relations with
others, and sleep. Two subdimensions of pain interference were
proposed: an affective subdimension (REM: relations with others,
enjoyment of life, and mood) and an activity subdimension (WAW:
walking, general activity, and work). The appropriate
categorization of sleep within these two subdimensions was
unclear.
A graphic representation of the conceptual framework for our
measurement model is shown below. The model conforms to the
U.S. Food and Drug Administration’s Draft Guidance for Industry,
Patient-reported Outcome Measures: Use in Medical Product
Development to Support Labeling Claims (Food and Drug
Administration, 2006).
REM
WAW
Interference
Pain Severity
Working
General Activity
Walking
Mood
Enjoyment of Life
Relations with Others
Pain Now
Average Pain
Least Pain
Worst Pain
Patient Pain Experience
Sleep?
CONSTRUCTS ITEMS
5
Early Version: The Wisconsin Brief Pain Questionnaire
The first version of our pain measure was the Wisconsin Brief Pain
Questionnaire (BPQ; Daut & Cleeland, 1982; Daut, Cleeland, &
Flanery, 1983). In the initial phase of scale development, 667
patients with cancer and 32 patients with rheumatoid arthritis were
administered a three-page questionnaire and interviewed about
the basic parameters of their pain (Daut et al., 1982). Patients who
had experienced pain in the last month were asked to rate their
pain intensity at itsworst,”average,” and now” and to rate the
extent to which pain had interfered with activity and enjoyment of
life. Patients were also asked to mark their pain location(s) on
front/back body diagrams and to describe their perception of the
cause of pain, the types of pain treatment they were receiving,
and the amount of relief provided by their treatment. Patients
were also asked to describe the quality of their pain by choosing
words among a list of verbal descriptors derived from the McGill
Pain Questionnaire (Melzack, 1975).
The design of the four-page BPQ was based on this initial
questionnaire. In the BPQ, a 010 numerical rating scale was used
to measure three pain severity items: “worst” in the past month,
average,” and “now,” where 0=no pain and 10=pain as bad as
you can imagine. The interference items were measured using a
five-option verbal descriptor scale, with ratings of 0=not at all, 1=a
little bit, 2=moderately, 3=quite a bit, and 4=extremely. The recall
period for both severity and interference scales was “in the last
week. The BPQ also retained the body diagram from the initial
questionnaire, along with word descriptors of pain quality and
questions about types and effectiveness of pain treatment, the
patient’s perception of the cause of pain, and certain
demographic information.
A second study (Daut et al., 1983) investigated the psychometric
properties of the BPQ. This set of analyses was based on BPQ data
obtained from more than 1200 patients with cancer at The
University of Wisconsin Cancer Center. To determine test-retest
characteristics of the BPQ, subsamples of patients completed the
BPQ on two or more occasions. For comparison with other disease
sites, a sample of patients with pain from rheumatoid arthritis was
also surveyed.
6
Most of the patients were able to complete the BPQ by
themselves with little or no instruction; others were interviewed to
complete the questionnaire. A subset 25 patients completed both
an interview-administered and self-administered version of the
survey in counterbalanced order. We found little difference in
ratings due to mode of administration. As expected, test-retest
reliability varied by item. Short (days) test-retest reliability was 0.93
for “worst pain,” but only 0.59 for “pain now.” Preliminary
exploration found that patient-reported pain severity and
interference were directly associated with the use of opioid
analgesics and the severity of disease.
The Brief Pain Inventory
The next iteration of our pain measure was the long form of the
Brief Pain Inventory (BPI; Cleeland, 1989; Cleeland, 1990; Cleeland,
1991; Cleeland & Ryan, 1994). In this new instrument, we added
the itemleast pain” to the severity items and dropped the
categorical rating scale for the interference items, in response to
patient preference. The interference items were now presented
with 010 scales, with 0=no interference and 10=interferes
completely. The initial version of the BPI used a recall period of one
week for both pain severity and pain interference ratings, included
questions about medication use, and asked the patient to check
potential pain quality descriptors that may describe their pain. The
BPI long form also asked questions about the percentage and
duration of pain relief and nonmedical methods used to relieve
pain.
This version of the BPI proved to be too lengthy for repeated use in
clinical monitoring or as a repeated measure in research. As a
result, we developed a shorter version of the BPI. This version of the
BPI retained the front and back body diagrams, the four pain
severity items and seven pain interference items rated on 010
scales, and the question about percentage of pain relief by
analgesics. The most important difference between the longer
and shorter versions of the BPI is that the latter uses a 24-hour recall
period.
Whereas the BPI long form is still used as a baseline measure in
clinical trials, the shorter version has become the standard for use
7
in clinical and research applications. The short form is typically
what is referred to when the BPI is cited in research, and it is the
version we describe below. Most psychometric evaluations of the
BPI have been performed on the short form.
Scoring the Brief Pain Inventory as an Outcome Measure
A recent consensus panel recommended that the two domains
measured by the BPI— pain intensity (severity) and the impact of
pain on functioning (interference)— be included as outcomes in all
chronic-pain clinical trials (IMMPACT, Turk et al., 2003). The
IMMPACT panel (www.immpact.org) specifically identified the
interference items of the BPI, rated on a 0–10 scale, as one of the
two scales recommended for assessment of pain-related
functional impairment (Dworkin et al., 2005).
How to Score the BPI: Pain Severity
The BPI assesses pain at its “worst,”least,”average,” andnow”
(current pain). In clinical trials, the items “worst” and “average”
have each been used singly to represent pain severity. A
composite of the four pain items (a mean severity score) is
sometimes presented as supplemental information. The use of
these single items is supported by the IMMPACT recommendations
for assessing pain in clinical trials (Dworkin et al., 2005; Turk et al.,
2006; Dworkin et al., 2008) and by the FDA Draft Guidance for
Industry: Patient-Reported Outcome Measures (Food and Drug
Administration, 2006). However, the BPI’s developers recommend
that all four severity items be used, because the models for
validation of the BPI included all four items.
How to Score the BPI: Pain Interference
The BPI measures how much pain has interfered with seven daily
activities, including general activity, walking, work, mood,
enjoyment of life, relations with others, and sleep. BPI pain
interference is typically scored as the mean of the seven
interference items. This mean can be used if more than 50%, or
four of seven, of the total items have been completed on a given
administration.
8
We are exploring the utility of scoring the activity and affective
dimensions described above (WAW and REM, see diagram [link])
as arithmetic means of these sets of items.
How to Score the BPI: Other Items
The item, “Throughout our lives, most of us have had pain from
time to time (such as minor headaches, sprains, and toothaches).
Have you had pain other than these everyday kinds of pain
today?” is a YES/NO preliminary screening question at the
beginning of the BPI. This item is optional and we have not
evaluated its psychometric properties. The BPI also asks the patient
to indicate the percentage of relief provided by pain treatments
or medications, but we have not found this item to be very useful
in our studies.
Psychometric Properties of the Brief Pain Inventory
Dimensions of the BPI: Two-Factor Structure
Several approaches have explored the underlying dimensions of
the BPI. As described above, the BPI was designed to capture two
dimensions of pain: severity and interference. The BPI was also
intended to capture two components of interference— activity
and affect (emotions).
One of the first studies of the dimensions of the BPI compared the
factor structure of four language versions of the BPI used to assess
cancer pain in the United States, Mexico, the Philippines, and
Vietnam (Cleeland, 1990). Factor analysis was applied to the
matrix of intercorrelations of the item scores of each sample. For
each language version, the same two factors emerged with an
eigenvalue greater than 1: the first factor comprised the pain
interference items and the second factor comprised the pain
severity items. The similarity of the factor loading among the
language versions indicated that patients experiencing cancer
and pain, living in various countries and speaking various
languages, responded to the items in a similar fashion.
This two-factor structure was confirmed in a large national study
conducted in the U.S. by the Eastern Cooperative Oncology
Group. Outpatients (N= 1261) with recurrent or metastatic cancer
9
from 80 centers were enrolled in the study (Cleeland et al., 1994).
Factor analysis verified the two separate factors, pain severity and
interference, found in the previous study. Internal stability
(Cronbach alpha) was also examined in this study. Alphas showed
good internal consistency, ranging from 0.80 to 0.87 for the four
pain severity items and from 0.89 to 0.92 for the seven interference
items. Subsequent data from studies of cancer patients in many
countries and many languages have demonstrated high internal
consistency and the robust nature of these two dimensions of the
BPI.
Dimensions of the BPI: Multidimensional Scaling of Interference
We have also used multidimensional scaling (MDS) to examine the
dimensions of the BPI. We used a four-country sample with BPI
responses from patients with cancer and pain (Cleeland et al.,
1996). In this MDS analysis, we focused on only the interference
items of the survey. Our purpose was to explore potential linguistic
and cultural differences in the report of pain interference.
As we had hypothesized, two dimensions of the interference scale
were demonstrated. The first dimension consisted of patients’
ratings of pain’s interference with enjoyment of life, mood, and
relations with others (REM, the affective cluster of interference
items). A second dimension of interference ratings consisted of
patients’ ratings of pains interference with walking, general
activity, work, and sleep (WAW, the activity cluster of interference
items). Subsequent studies of additional language versions (Hindi in
Saxena, Mendoza, & Cleeland, 1999; Norwegian in Klepstad et al.,
2002) have shown a similar decomposition of the interference
items into the affective (REM) and activity (WAW) interference
subscales.
In summary, there is strong psychometric support for the
independent measurement of pain severity and interference in
the BPI. In addition, there is provisional evidence that the
interference items independently measure activity and affective
interference.
10
Test-Retest Reliability
Values from any measure should not differ significantly between
assessments. The underlying concept of a measure should not
change between assessments. This psychometric concept applies
to patient-report instruments and is examined by test-retest
reliability.
The test-retest reliability of the BPI has been studied in cancer
patients and other patients with pain. Initial short-term (1 day to 1
week) reliability for ratings of painworst” (0.93) and “usual” or
average” pain (0.78) in patients with cancer was high, which
signals acceptable reliability. As expected, test-retest reliability for
pain now” severity ratings were lower (0.59), because pain
intensity often changes over time (Daut et al., 1983).
Several more recent studies have found similar test-retest
coefficients for these items. For example, Radbruch et al. (1999)
examined test-retest coefficients in 109 outpatients in a German
pain clinic, with the retest occurring 30 to 60 minutes after the first
administration. Test-retest values were 0.98 for pain severity and
0.97 for pain interference. The individual item with the lowest
value, 0.78, was pain “least.”
Reliabilities have also been examined with daily administration of
the BPI. In patients with osteoarthritis (Mendoza et al., 2006), test-
retest reliabilities of pain severity (pain worst,”average,” and
current”) between consecutive daily administration for a week
showed correlations ranging from 0.83 to 0.88. The test-retest
reliabilities for pain interference ranged from 0.83 to 0.93,
beginning at day 1 for the week.
In another study of patients who underwent coronary artery
bypass graft, the test-retest reliability coefficients for pain severity
ranged from 0.72 to 0.95 during assessment periods where
postsurgical pain declined in an expected direction (Mendoza et
al., 2004). Similarly, the test-retest reliability coefficients for pain
interference ranged from 0.81 to 0.93 during the same assessment
period.
11
Test-Retest Reliability and Alternate-Forms Reliability: the Hindi
Translation
Finally, one study combined an examination of both test-retest
reliability and alternate-forms reliability (Saxena et al., 1999). In this
study, 100 patients with cancer who spoke both English and Hindi
completed both language versions of the BPI on different days in a
counterbalanced design. In addition to reporting reliability based
on internal consistency, the study design allowed calculation of
the alternate-forms reliability of the BPI. Treating the Hindi and
English versions of the BPI as alternate test forms, the alternate-form
reliabilities of the interference and severity subscales were 0.88
and 0.95, respectively. These reliabilities demonstrated that the
Hindi and English versions could be substituted for one another in
assessing the severity of pain and its impact in bilingual patients.
These data also provided support for the high test-retest reliability
of the BPI.
In summary, the BPI is reliable to the extent that high test-retest
reliability and alternate-form reliability is demonstrated when pain
is stable or when pain changes in a predictable way.
References
American Psychological Association, American Educational
Research Association, National Council on Measurement in
Education. Standards for Educational and Psychological Tests.
Washington DC: 1974.
Cleeland CS. The impact of pain on the patient with cancer.
Cancer 54(11 Suppl): 2635-2641, 12/1984.
Cleeland CS. Measurement of pain by subjective report. In:
Chapman CR, Loeser JD, editors. Issues in Pain Measurement.
New York: Raven Press; pp. 391-403, 1989 Advances in Pain
Research and Therapy; Vol. 12.
Cleeland CS. Assessment of pain in cancer: measurement issues.
In: Foley KM, Bonica JJ, Ventafridda V, editors. Proceedings of
the Second International Congress on Cancer Pain. New York:
Raven Press; pp. 47-55, 1990 Advances in Pain Research and
Therapy; Vol. 16.
12
Cleeland CS. Pain assessment in cancer. In: Osoba D, editor. Effect
of Cancer on Quality of Life. Boca Raton: CRC Press, Inc.; pp.
293-305, 1991.
Cleeland CS, Gonin R, Hatfield AK, Edmonson JH, Blum RH, Stewart
JA, Pandya KJ. Pain and its treatment in outpatients with
metastatic cancer. N Engl J Med 330(9): 592-596, 3/1994.
Cleeland CS, Nakamura Y, Mendoza TR, Edwards KR, Douglas J,
Serlin RC. Dimensions of the impact of cancer pain in a four
country sample: new information from multidimensional
scaling. Pain 67(2-3): 267-273, 10/1996.
Cleeland CS, Ryan KM. Pain assessment: global use of the Brief
Pain Inventory. Ann Acad Med Singapore 23(2): 129-138,
3/1994.
Daut RL, Cleeland CS. The prevalence and severity of pain in
cancer. Cancer 50(9): 1913-1918, 11/1982.
Daut RL, Cleeland CS, Flanery RC. Development of the Wisconsin
Brief Pain Questionnaire to assess pain in cancer and other
diseases. Pain 17(2): 197-210, 10/1983.
Dworkin RH, Turk DC, Farrar JT, Haythornthwaite JA, Jensen MP,
Katz NP, Kerns RD, Stucki G, Allen RR, Bellamy N, Carr DB,
Chandler J, Cowan P, Dionne R, Galer BS, Hertz S, Jadad AR,
Kramer LD, Manning DC, Martin S, McCormick CG, McDermott
MP, McGrath P, Quessy S, Rappaport BA, Robbins W, Robinson
JP, Rothman M, Royal MA, Simon L, Stauffer JW, Stein W, Tollett
J, Wernicke J, Witter J. Core outcome measures for chronic
pain clinical trials: IMMPACT recommendations. Pain 113(1-2):
9-19, 1/2005.
Dworkin RH, Turk DC, Wyrwich KW, Beaton D, Cleeland CS, Farrar
JT, Haythornthwaite JA, Jensen MP, Kerns RD, Ader DN,
Brandenburg N, Burke LB, Cella D, Chandler J, Cowan P,
Dimitrova R, Dionne R, Hertz S, Jadad AR, Katz NP, Kehlet H,
Kramer LD, Manning DC, McCormick C, McDermott MP,
McQuay HJ, Patel S, Porter L, Quessy S, Rappaport BA,
Rauschkolb C, Revicki DA, Rothman M, Schmader KE, Stacey
BR, Stauffer JW, von ST, White RE, Witter J, Zavisic S. Interpreting
the clinical importance of treatment outcomes in chronic pain
13
clinical trials: IMMPACT recommendations. J Pain 9(2): 105-121,
2/2008.
Food and Drug Administration. Guidelines for Industry (draft).
Patient-Reported Outcome Measures: Use in Medical Product
Development to Support Labeling Claims. 2006. Rockville MD,
U.S. Department of Health and Human Services.
Ref Type: Report
Klepstad P, Loge JH, Borchgrevink PC, Mendoza TR, Cleeland CS,
Kaasa S. The Norwegian Brief Pain Inventory questionnaire:
translation and validation in cancer pain patients. J Pain
Symptom Manage 24(5): 517-525, 11/2002.
Melzack R. The McGill Pain Questionnaire: major properties and
scoring methods. Pain 1(3): 277-299, 9/1975.
Melzack R, Casey KL. Sensory, motivational, and central control
determinants of pain: a new conceptual model. In: Kenshalo
DR, editor. The Skin Senses Proceedings. Springfield IL: Thomas;
pp. 423-439, 1968.
Mendoza T, Mayne T, Rublee D, Cleeland C. Reliability and validity
of a modified Brief Pain Inventory short form in patients with
osteoarthritis. Eur J Pain 10(4): 353-361, 5/2006.
Mendoza TR, Chen C, Brugger A, Hubbard R, Snabes M, Palmer SN,
Zhang Q, Cleeland CS. The utility and validity of the modified
Brief Pain Inventory in a multiple-dose postoperative analgesic
trial. Clin J Pain 20(5): 357-362, 9/2004.
Radbruch L, Loick G, Kiencke P, Lindena G, Sabatowski R, Grond S,
Lehmann KA, Cleeland CS. Validation of the German version of
the Brief Pain Inventory. J Pain Symptom Manage 18(3): 180-
187, 9/1999.
Saxena A, Mendoza T, Cleeland CS. The assessment of cancer
pain in north India: the validation of the Hindi Brief Pain
Inventory--BPI-H. J Pain Symptom Manage 17(1): 27-41, 1/1999.
Turk DC, Dworkin RH, Allen RR, Bellamy N, Brandenburg N, Carr DB,
Cleeland CS, Dionne R, Farrar JT, Galer BS, Hewitt DJ, Jadad
AR, Katz NP, Kramer LD, Manning DC, McCormick CG,
McDermott MP, McGrath P, Quessy S, Rappaport BA, Robinson
14
JP, Royal MA, Simon L, Stauffer JW, Stein W, Tollett J, Witter J.
Core outcome domains for chronic pain clinical trials:
IMMPACT recommendations. Pain 106: 337-345, 2003.
Turk DC, Dworkin RH, Burke LB, Gershon R, Rothman M, Scott J,
Allen RR, Atkinson JH, Chandler J, Cleeland C, Cowan P,
Dimitrova R, Dionne R, Farrar JT, Haythornthwaite JA, Hertz S,
Jadad AR, Jensen MP, Kellstein D, Kerns RD, Manning DC,
Martin S, Max MB, McDermott MP, McGrath P, Moulin DE,
Nurmikko T, Quessy S, Raja S, Rappaport BA, Rauschkolb C,
Robinson JP, Royal MA, Simon L, Stauffer JW, Stucki G, Tollett J,
von ST, Wallace MS, Wernicke J, White RE, Williams AC, Witter J,
Wyrwich KW. Developing patient-reported outcome measures
for pain clinical trials: IMMPACT recommendations. Pain 125(3):
208-215, 12/2006.
15
Chapter 2
BPI References: Use of the BPI in
Various Studies
The Brief Pain Inventory has been used in more
than 400 studies worldwide. Here we present BPI
references categorized by type of study.
Cancer Bone Pain .................................................16
Cancer Epidemiology...........................................20
Cancer Pain...........................................................21
Depressive Disorders..............................................31
Fabry Disease.........................................................32
Fibromyalgia ..........................................................33
HIV/AIDS.................................................................34
Minority Studies......................................................35
Neuromuscular Pain ..............................................36
Neuropathic Pain...................................................40
Osteoarthritis and Other Joint Diseases................42
Psychosocial Studies..............................................45
Surgical and Procedural Pain ...............................46
Validation Studies..................................................49
Language Translations...........................................58
Methods Papers.....................................................59
16
Cancer Bone Pain
1. Ahles TA, Herndon JE, Small EJ, Vogelzang NJ, Kornblith AB,
Ratain MJ, Stadler W, Palchak D, Marshall ME, Wilding G,
Petrylak D, Holland JC. Quality of life impact of three different
doses of suramin in patients with metastatic hormone-
refractory prostate carcinoma: results of Intergroup
O159/Cancer and Leukemia Group B 9480. Cancer 101(10):
2202-2208, 11/2004.
2. Borden LS, Jr., Clark PE, Lovato J, Hall MC, Stindt D, Harmon M,
Mohler M, Torti FM. Vinorelbine, doxorubicin, and prednisone
in androgen-independent prostate cancer. Cancer 107(5):
1093-1100, 9/2006.
3. Callstrom MR, Charboneau JW, Goetz MP, Rubin J, Wong GY,
Sloan JA, Novotny PJ, Lewis BD, Welch TJ, Farrell MA, Maus TP,
Lee RA, Reading CC, Petersen IA, Pickett DD. Painful
metastases involving bone: feasibility of percutaneous CT-
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