Because this study
was designed to evaluate the operating characteristics of pain
screening in real practice, we did not retrain clinic staff or alter
preexisting pain screening protocols. Based on previous
studies and clinical practice, we categorized pain screening
NRS scores as mild (1–3), moderate (4–6), or severe (7–10).
Studies of chronic pain patients with different conditions have
reached varying conclusions about the optimal cut points for
mild, moderate, and severe pain on the 0–10 NRS, with 4 or 5
being the most commonly recommended lower limits for
moderate pain and 7 or 8 for severe pain.12–17 We chose a
score of 4 as the lower limit for moderate pain because it is
most commonly accepted for clinical and administrative use