Objective: To compare different methods for measuring pelvic pain intensity in a gynecologic emergency unit.
Methods: A total of 177 consecutive female patients, with or without pain, consulting in a gynecologic emergency unit, underwent initial pain evaluation. We used three self-report pain intensity scales: visual analog scale, numeric rating scale, and verbal rating scale, and two nonverbal structured behavioral indices (BI-1, first behavioral index, BI-2 second behavioral index). Diagnosis and treatment took place in routine manner.
Results: The five scales were unidimensional according to principal component analysis (Cronbach's alpha coefficient=0.89). Missing data rates were greater for the two behavioral scales than for the self-report scales (n=177; 6.2% for BI-1 and 12.4% for BI-2). Patients had lower scores with the behavioral scales than with the self-report ones. Variations of pain intensity according to the pain physiology or the pain location were similar whatever the method of measurement used. The five methods were all sensitive to the physiology of the pain, the location and the severity of the illness, and pain as a main complaint. None of the methods used was affected by age, occupational categories, parity, or geographical origins.
Conclusion: All methods adequately measured the pelvic pain intensity in gynecologic emergencies. The self-report scales were easier to use than the behavioral indices. Self-report measurements of pelvic pain intensity provide useful information at the time of triage in gynecologic emergency departments.
Level of evidence: II.