Background & Aims

Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder associated with low-grade painful episodes and subfertility. PCOS pain in the pelvic or lower abdomen is the most commonly reported symptom that negatively affects a person’s quality of life. In pain studies, the Numerical Rating Scale (NRS) is often used to assess pain intensity. This is a single-item scale, with 0 indicating no pain and 10 representing the worst possible pain. However, for the assessment of PCOS-related pain intensity, there are no studies on the test-retest reliability and measurement error of the NRS. Therefore, the aim of this study was to evaluate the test-retest reliability and measurement error of the NRS for assessing pain intensity in women with PCOS.

Methods

This is a repeated-measures, online study conducted between January 2022 and March 2023 among Brazilian women with a medical diagnosis of PCOS. Women were excluded if they were postmenopausal, pregnant, and 12 months postpartum. All participants responded to the NRS via Google Forms in relation to the most recent menstrual cycle. Participants responded to the NRS 24 hours after the first assessment. We analyze data from women who had painful menstruation at the test and retest. For the test-retest reliability, the intraclass correlation coefficient (ICCagreement) was used with a two-way mixed-effects model in SPSS 22. An ICC>0.75 was an adequate measure of reliability. Measurement error was calculated by Standard Error of Measurement (SEMagreement) with the formula [diferenceSD/?2] and Smallest Detectable Change (SDCagreement) using the formula [SEM*1.96*?2]. The diferenceSD indicates the standard deviation (SD) of the difference between the test and retest scores of the NRS.

Results

Four hundred and seventy-five women (15 to 50 years) with PCOS participated in the study. Analyses included data from 132 (27.8%) women with a 24-hour response and painful menstruation at test and retest. Most participants had higher education (98.5%) and menarche at age 12 (31.1%). The mean age of the participants and pain intensity at the test and retest NRS were 28.5±7.0 years, 6.8±2.3 points, and 6.5±2.5 points, respectively. The ICC was 0.863 (95%CI 0.804 – 0.904). The measurement error was: SEM = 1.8 and SDC = 4.9.

Conclusions

The NRS is a reliable measure of pain intensity in women with PCOS. Health care professionals and researchers can use this tool to monitor pain intensity in this population in clinical practice and scientific research.

References

Shrivastava S, Conigliaro RL. Polycystic Ovarian Syndrome. Med Clin North Am . 2023 Mar;107(2):227-234. doi: 10.1016/j.mcna.2022.10.004.

de Arruda GT, Driusso P, Rodrigues JC, de Godoy AG, Avila MA. Numerical rating scale for dysmenorrhea-related pain: a clinimetric study. Gynecol Endocrinol. Published online July 19, 2022:1-5. doi:10.1080/09513590.2022.2099831

de Arruda GT, Driusso P, de Godoy AG, Rodrigues JC, Avila MA. Presenteeism and associated factors among women with menstrual symptoms. Arch Gynecol Obstet. Published online March 19, 2024. doi:10.1007/s00404-024-07425-1

de Arruda GT, Driusso P, Rodrigues JC, et al. Are menstrual symptoms associated with central sensitization inventory? A cross?sectional study. Eur J Pain. Published online July 6, 2022. doi:10.1002/ejp.1999

Presenting Author

Mariana Avila

Poster Authors

Mariana Avila

PhD

Universidade Federal de São Carlos

Lead Author

Guilherme de Arruda

PT

Physical Therapy Post-Graduate Program, UFSCar

Lead Author

Barbara da Silva

PT Student

Physical Therapy Department, UFSCar

Lead Author

Maria Eduarda Batista da Silva

PT Student

Physical Therapy Department, UFSCar

Lead Author

Patricia Driusso

PT

Physical Therapy Department and Physical Therapy Post-Graduate Program, UFSCar

Lead Author

Topics

  • Specific Pain conditions/Pain in Specific Populations: Gynecological Pain