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NINDS CDE Notice of Copyright
Brief Pain Inventory (BPI) Long Form
Please visit this website for more information about the instrument: Brief Pain Inventory
The Brief Pain Inventory (BPI) copyright is held by Charles S. Cleeland, PhD (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 Dr. Cleeland or his designee. Fees for use may apply.
The BPI may be ordered from:
Department of Symptom Research
Attn: Assessment Tools
The University of Texas MD Anderson Cancer Center
1515 Holcombe Boulevard, Unit 1450
Houston, Texas 77030
Supplemental: Cerebral Palsy (CP)
Short Description of Instrument
The Brief Pain Inventory (BPI) rapidly assesses the severity of pain and its impact on functioning. The BPI has been translated into dozens of languages, and it is widely used in both research and clinical settings.
The BPI Long Form, which contains additional descriptive items that may be clinically useful (e.g., items that expand the possible descriptors of pain, such as burning, tingling, etc.)
Construct measured: Pain.
Generic vs. disease specific: Generic.
Means of administration: Self-Assessment/Interview.
Time required: 10 minutes.
Intended respondent: Patient.
# of items: 32.
# of subscales and names of sub-scales: N/A.
# of items per sub-scale: N/A.
Comments/Special Instructions
The 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.
Administration: The BPI is a self-assessment scale. For patients who cannot complete the scale themselves, interview the patient reading all questions as written and slowly enough for the patient to consider each statement and respond. The short version takes 5 minutes to complete, and the long version takes 10 minutes to complete.
CP-specific Long Form Pain Categories: Intensity, Interference, Location, and Quality
CP-specific ICF Domains: Body Structures, Body Functions, Activity and Participation (World Health Organization, 2001)
Scoring and Psychometric Properties
Scoring: The BPI Long Form includes 32 items. Items 1-10 collect information on demographics and history. Item 11 is a body diagram. Items 12-15 use a 0-10 numeric rating scale regarding pain intensity. Items 16-21 are open-ended and multiple selection questions about pain relief, causes and triggers of pain and treatment. Item 22 is a chart with pain descriptors, item 23 uses a 0-10 numeric rating scale for 7 sub questions related to pain interference, and items 24-32 are questions regarding use of pain medication and pain relief.
Psychometric Properties: 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 pain "worst" (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). 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. Validated in cancer and non-cancer pain, and in three dozen languages.
Responsiveness: Responds to both behavioral and pharmacological pain interventions.
Reliability: Cronbach alpha reliability ranges from 0.77 to 0.91.
Internal consistency of the BPI has been demonstrated in a series of studies. Cronbach alpha coefficients for the pain intensity scale have ranged from 0.78 to 0.96 (Atkinson et al., 2010).
CP-specific: Modified BPI scores were internally consistent (Cronbach a = 0.96) and correlated significantly with Numeric Rating Scale intensity scores, Dalhousie Pain Interview pain intensity, pain frequency, and pain duration scores. Modified BPI scores also significantly decreased after spasticity treatment (Barney et al., 2018)
Strengths: 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.
Weaknesses: It is not recommended to use BPI item 9 a - g, dealing with pain's interference with functions because the performance of this item may be confounded by other motor and nonmotor impairments. Overall, individuals with cognitive and motor impairments may have difficulty completing the assessment.
Key Reference:
Cleeland C. The Brief Pain Inventory User's Guide., 2009. Brief Pain.
Additional References:
Atkinson TM, Mendoza TR, Sit L, Passik S, Scher HI, Cleeland C, Basch E. The Brief Pain Inventory and its "pain at its worst in the last 24 hours" item: clinical trial endpoint considerations. Pain Med. 2010 Mar;11(3):337-346.
Atkinson TM, Rosenfeld BD, Sit L, Mendoza TR, Fruscione M, Lavene D, Shaw M, Li Y, Hay J, Cleeland CS, Scher HI, Breitbart WS, Basch E. Using confirmatory factor analysis to evaluate construct validity of the Brief Pain Inventory (BPI). J Pain Symptom Manage. 2011 Mar;41(3):558-565.
Barney CC, Stibb SM, Merbler AM, Summers RLS, Deshpande S, Krach LE, Symons FJ. Psychometric properties of the brief pain inventory modified for proxy report of pain interference in children with cerebral palsy with and without cognitive impairment. Pain Rep. 2018 Jul 17;3(4):e666.
Cleeland C. Research in cancer pain. What we know and what we need to know. Cancer. 1991 Feb 1;67(3 Suppl):823-827.
Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singap. 1994 Mar;23(2):129-138.
Daut RL, Cleeland CS, Flanery RC. Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases. Pain. 1983 Oct;17(2):197-210.
Keller S, Bann CM, Dodd SL, Schein J, Mendoza TR, Cleeland CS. Validity of the brief pain inventory for use in documenting the outcomes of patients with noncancer pain. Clin J Pain. 2004 Sep-Oct;20(5):309-18.
Tan G, Jensen MP, Thornby JI, Shanti BF. Validation of the Brief Pain Inventory for chronic nonmalignant pain. J Pain. 2004 Mar;5(2):133-7.
World health Organization (2001). International Classification of Functioning, Disability and Health (ICF) Retrieved 19August2021
Document last updated August 2022