Written and maintained by CASRAI Editorial Board
Last updated
Not medical advice. This page describes a research and clinical measurement instrument. It does not interpret any individual’s pain score.
Short answer
The Brief Pain Inventory (BPI) is a patient-completed questionnaire that rapidly assesses the severity of pain and its impact on functioning. It was developed for cancer pain and is now used across clinical practice, epidemiology and treatment-effectiveness studies. Its developer, the MD Anderson Symptom Research group, states that it has no formal scoring algorithm, but gives simple means for severity and interference.
Definition and scope
A 1994 review by Cleeland and Ryan in Annals of the Academy of Medicine, Singapore (23(2):129-38, “Pain assessment: global use of the Brief Pain Inventory”) describes it as measuring pain intensity and interference with daily life, together with pain relief, pain quality and the patient’s perceived cause of pain. The same paper reports reliability and validity across cultures and languages. In research-administration terms it is a patient-reported outcome measure, the same family as the PHQ-9 and GAD-7; see also ePRO for electronic collection.
Items and subscales
According to the MD Anderson BPI page, the instrument has two scored dimensions.
| Dimension | Items | What the items cover |
|---|---|---|
| Pain severity | 4 | Worst pain, least pain (both over the past 24 hours), average pain, and pain right now |
| Pain interference | 7 | General activity, mood, walking ability, normal work (including housework), relations with other people, sleep, enjoyment of life |
How BPI scoring works
The developer’s page says there is “no scoring algorithm”. It adds that severity can be measured with the worst-pain item alone or with the mean of the four severity items, and that interference can be measured with the mean of the seven interference items. That gives researchers two practical summaries: a severity score and an interference score. Analysis plans should state which severity summary (worst pain or four-item mean) is used, because the developer allows either.
This page does not give cut-offs for “mild”, “moderate” or “severe” pain. Those are interpretive choices that belong to the study protocol or clinical policy, not to the questionnaire form.
Long form, short form and disease-specific versions
The MD Anderson page lists a long form and disease-specific versions, including diabetes and herpes zoster versions. Of the disease-specific versions it notes that only English is psychometrically validated. The “Zoster Brief Pain Inventory” and the diabetes version are therefore adaptations of the same core design, not different instruments with their own scoring rules; use the developer’s documentation for the exact version you adopt.
Languages and permissions
The developer lists dozens of translations and groups them as either “Psychometrically and Linguistically Validated” or “Linguistically Validated” only. English and Spanish have a linguistically validated long form. This distinction matters when a multi-site study plans to pool scores across languages: a linguistically validated translation has been checked for wording, not necessarily tested for measurement properties.
The BPI is ordered through an online request form. MD Anderson lists the use categories on that form as clinical research or practice, academic or commercial research, and educational reproduction. The BPI User’s Guide is provided on emailed request. Labs, clinics and sponsors should therefore obtain the form and the version-specific guide from the developer rather than reuse an uncontrolled copy of the form.
Where it matters for labs, clinics and supply decisions
Pain-focused clinics and trial sites that collect patient-reported outcomes need a controlled version of the instrument as part of their study or quality documentation. For the operational side of such a clinic, see the pain management clinic supply checklist; for hospital-level use of patient-reported measures, see patient-reported outcome measures and hospital quality.
Common misunderstandings
- “It produces one total score.” The developer describes separate severity and interference summaries, not a single total.
- “It is only for cancer.” It was developed for cancer pain, but the 1994 review and the existence of diabetes and herpes zoster versions show wider use.
- “Any translation is validated.” Only some translations are psychometrically validated; others are linguistically validated only.
- “It is free to copy.” The developer routes use through a request form.
FAQ
What does the Brief Pain Inventory measure?
Pain severity (four items) and pain interference with function (seven items), per the MD Anderson Symptom Research page.
How is the Brief Pain Inventory scored?
There is no formal algorithm. Severity is the worst-pain item or the mean of the four severity items; interference is the mean of the seven interference items.
Where can I get the BPI long form or short form?
From the developer’s online request form at MD Anderson, which covers clinical, research and educational uses. The BPI User’s Guide is available by email request.
Sources
- MD Anderson Cancer Center, Symptom Research: Brief Pain Inventory, read 2026-11-07.
- Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singap 1994;23(2):129-38. PubMed 8080219, read 2026-11-07.
