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Table 6 Patients’ descriptors used for the ESD “worst pelvic pain” 0–10 NRS

From: Patients’ and clinicians’ perspectives on item importance, scoring, and clinically meaningful differences for the Endometriosis Symptom Diary (ESD) and Endometriosis Impact Scale (EIS)

NRS Patients’ descriptors for each pain level of the ESD “worst pelvic pain” 0–10 NRS
0 No pain
1 The pain is barely noticeable, patients are functional, able to work, and not taking medication
2 The pain is still mostly barely noticeable and described as “mild.” A minority of patients experience feelings of irritation
3 The pain is becoming more noticeable and a little bothersome—the majority of patients continue to describe it as “mild” but for some it is becoming more “moderate.” Patients are beginning to experience slight limitations in their functionality
4 The pain is now largely described as “moderate.” Function is slightly limited for many patients, but patients generally remain active, albeit feeling frustrated and irritable due to the increasing pain. Many patients begin taking mild medication –mostly NSAIDs
5 “Mild,” “moderate,” and “severe” are all descriptors used by participants to describe pain at NRS = 5, although the majority continue to consider this a “moderate” level pain. In addition, patients begin to experience slight emotional distress and/or begin the use of mild medication. No changes in functionality are reported
6 Patients are now less functional and reducing their workload; putting off chores that don’t need to be completed imminently. Patients continue to attend work, but may then dedicate their evenings to rest. A minority of patients begin to use stronger pain medication—for example, narcotics
7 Patients largely describe NRS = 7 as severe pain. Patients are doing only the “bare minimum” of daily chores, and a minority of patients do not attend work. Many patients begin to use stronger pain medication
8 All patients describe the pain as “severe.” Many patients do not attend work, and of those that continue to attend, they are reducing their duties. More patients still begin to use stronger pain medication
9 Pain continues to increase in severity. Patients are physically incapacitated
10 The pain is so severe that many patients find they need to go to hospital. The pain may be so agonizing that patients are vomiting. Patients describe feeling like they are dying
  1. ESD = Endometriosis Symptom Diary; NRS = numerical rating scale; NSAID = non-steroidal anti-inflammatory drug