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Systematic review of endometriosis pain assessment: how to choose a scale?

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Bourdel, Nicolas, Alves, João, Pickering, Gisele, Ramilo, Irina, Roman, Horace, Canis, Michel·2015·Human Reproduction Update
DOI 10.1093/humupd/dmu046
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Abstract

BACKGROUND: Numerous studies concerning endometriosis and pain have been reported. However, there is no consensus on the best method to evaluate pain in endometriosis and many scales have been used. Moreover, there are only a few descriptions of minimal clinically important differences after treatment (MCID) to evaluate variations in pain. In our study, we aim to identify pain scales used in endometriosis pain treatment, to address their strong and weak points and to define which would be the ideal scale to help clinicians and researchers to evaluate endometriosis-related pain. METHODS: A search of the MEDLINE and EMBASE databases was carried out for publications in English, French or Portuguese from 1980 to December 2012, for the words: endometriosis, treatment, pain. Studies were selected if they studied an endometriosis treatment and a pain scale was specified. A quantitative and a qualitative analysis of each scale was performed to define strong and weak points of each scale (systematic registration number: CRD42013005336). RESULTS: A total of 736 publications were identified. After excluding duplications and applying inclusion criteria 258 studies remained. We found that the visual analog scale (VAS) is the most frequently used scale. Both VAS and the numerical rating scale (NRS) show a good balance between strong and weak points in comparison with others such as the Biberoglu and Behrman scale. Concerning MCID, only VAS, NRS and Brief Pain Inventory scales have reported MCID and, among these, only VAS MCID has been studied in endometriosis patients (VAS MCID = 10 mm). Adding the Clinical Global Impression score (CGI) to the pain scale allows calculation of the MCID. CONCLUSIONS: When using pain scales their strengths and weaknesses must be known and included in the analysis. VAS is the most frequently used pain scale and, together with NRS, seems the best adapted for endometriosis pain measurement. The use of VAS or NRS for each type of typical pain related to endometriosis (dysmenorrhea, deep dyspareunia and non-menstrual chronic pelvic pain), combined with the CGI and a quality-of-life scale will provide both clinicians and researchers with tools to evaluate treatment response.

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Metadata

Authors
Bourdel, N., Alves, J., Pickering, G., Ramilo, I., Roman, H., & Canis, M.
Venue
Human Reproduction Update
Publisher
Oxford University Press (OUP)
Published
2014-09-01
Volume
21
Issue
1
Pages
136-152
ISSN
  • 1355-4786 (ISSN-L)
  • 1460-2369
DOI
10.1093/humupd/dmu046
OpenAlex
W2162506788
Cited by
372
References
58
FWCI
2.64
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Systematic review of endometriosis pain assessment: how to choose a scale? https://app.cochat.ai/papers/10.1093/humupd/dmu046
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Bourdel, N., Alves, J., Pickering, G., Ramilo, I., Roman, H., & Canis, M. (2015). Systematic review of endometriosis pain assessment: how to choose a scale? Human Reproduction Update. https://doi.org/10.1093/humupd/dmu046

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