The Brief Pain Inventory

The Brief Pain Inventory (BPI) is available in two formats: the BPI short form, which is used for clinical trials and is the version used for the foreign-language translations; and the BPI long form, which contains additional descriptive items that may be clinically useful (for example, items that expand the possible descriptors of pain, such as burning, tingling, etc.). For brevity’s sake and for the patient’s ease of use, however, we recommend the short form of the BPI.

In response to the FDA draft guidance for the pharmaceutical industry on the use of patient-reported outcomes (PRO) measures in medical product development to support labeling claims, we have prepared a BPI User's Guide to provide documentation of the BPI's development and psychometric properties. The information offered therein addresses the recommendations in the FDA draft guidance and establishes the BPI's adequacy as a measure to support medical product claims.

BPI Features

• Purpose: To assess the severity of pain and the impact of pain on daily functions
• Population: Patients with pain from chronic diseases or conditions such as cancer, osteoarthritis and low back pain, or with pain from acute conditions such as postoperative pain
• Assessment Areas: Severity of pain, impact of pain on daily function, location of pain, pain medications and amount of pain relief in the past 24 hours or the past week
• Responsiveness: Responds to both behavioral and pharmacological pain interventions
• Method: Self-report or interview
• Time required: Five minutes (short form), 10 minutes (long form)
• Scoring: No scoring algorithm, but "worst pain" or the arithmetic mean of the four severity items can be used as measures of pain severity; the arithmetic mean of the seven interference items can be used as a measure of pain interference
• Reliability: Cronbach alpha reliability ranges from 0.77 to 0.91
• Validation: The BPI has been validated in more than three dozen languages by examining the consistency of its two-factor structure (factors: severity of pain and impact of pain)

BPI Language Versions

The BPI is available in the languages shown below. The BPI may not be modified or translated into another language without the express written consent of the copyright holder, Dr. Charles S. Cleeland (see Notice of Copyright below).

Click on a linked language to view a sample in PDF format.

* A linguistically validated version of the BPI Long Form (PDF) is available in this language.

Future Validation Studies: We would like to collaborate with other investigators to develop and validate new language versions of the BPI. Contact us for more information.

To Order the BPI

To use the BPI in a publication or clinical or research trial, you must obtain permission and you must agree to comply with the copyright. Fees may apply (see below).

• Fill out our permission form. The BPI will be e-mailed to you as a PDF file within seven to 10 business days. If your request is urgent, please contact us via e-mail or at the address/phone number below to make special arrangements.

The Department of Symptom Research
Attn: Lori F. Smith
The University of Texas M. D. Anderson Cancer Center
1515 Holcombe Boulevard, Unit 1450
Houston, Texas 77030
713-745-3805

• The fee structure is as follows:
  • Non-funded academic research and individual clinical practice
    • Free of charge
  • Funded academic research
    • $300 per project for the first language version
    • $50 per each additional language version within a project
  • Commercial research
    • $800 per project for the first language version
    • $400 per each additional language version within a project

If applicable, an invoice will be e-mailed to you within 10 days. Please reference the invoice number on your payment. Include on the memo line, "M. D. Anderson Assessment Tool Distribution."

Notice of Copyright

The Brief Pain Inventory (BPI) copyright is held by Dr. Charles S. Cleeland (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 Charles S. Cleeland, PhD, or his designee. Fees for use may apply (see above).

The BPI may not be modified or translated into another language without the express written consent of the copyright holder. Failure to comply may result in legal action. Contact us via e-mail or at the address shown above to obtain permission to alter or translate the instrument.

Selected References

Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore 23(2): 129-138, 1994.

Cleeland CS. Measurement of pain by subjective report. In: Chapman CR, Loeser JD, editors. Advances in Pain Research and Therapy, Volume 12: Issues in Pain Measurement. New York: Raven Press; 1989. p. 391-403.

Shi Q, Wang XS, Mendoza TR, Pandya KJ, Cleeland CS. Assessing persistent cancer pain: a comparison of current pain ratings and pain recalled from the past week. J Pain Symptom Manage, in press.

Kalyadina SA, Ionova TI, Ivanova MO, Uspenskaya OS, Kishtovich AV, Mendoza TR, Guo H, Novik A, Cleeland CS, Wang XS. Russian Brief Pain Inventory: validation and application in cancer pain. J Pain Symptom Manage 35(1): 95-102, 2008.

Dworkin RH, Turk DC, Wyrwich KW, Beaton D, Cleeland CS, Farrar JT, Haythornthwaite JA, Jensen MP, Kerns RD, Ader DN, Brandenburg N, Burke LB, Cella D, Chandler J, Cowan P, Dimitrova R, Dionne R, Hertz S, Jadad AR, Katz NP, Kehlet H, Kramer LD, Manning DC, McCormick C, McDermott MP, McQuay HJ, Patel S, Porter L, Quessy S, Rappaport BA, Rauschkolb C, Revicki DA, Rothman M, Schmader KE, Stacey BR, Stauffer JW, von ST, White RE, Witter J, Zavisic S. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain 9(2): 105-121, 2008.

Reyes-Gibby CC, Ba DN, Phi YN, Hoai NN, Van TT, Guo H, Bhat S, Cleeland C. Status of cancer pain in Hanoi, Vietnam: a hospital-wide survey in a tertiary cancer treatment center. J Pain Symptom Manage 31(5): 431-439, 2006.

Cleeland CS. The measurement of pain from metastatic bone disease: capturing the patient's experience. Clin Cancer Res 12(20 Part 2): 6236s-6242s, 2006.

Mendoza TR, Mayne T, Rublee D, Cleeland CS. Reliability and validity of a modified Brief Pain Inventory short form in patients with osteoarthritis. Eur J Pain 10(4): 353-361, 2006.

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 20(5): 309-318, 2004.

Mendoza TR, Chen C, Brugger A, Hubbard R, Snabes M, Palmer SN, Zhang Q, Cleeland CS. The utility and validity of the modified Brief Pain Inventory in a multiple-dose postoperative analgesic trial. Clin J Pain 20(5): 357-362, 2004.

Yun YH, Mendoza TR, Heo DS, Yoo T, Heo BY, Park HA, Shin HC, Wang XS, Cleeland CS. Development of a cancer pain assessment tool in Korea: A validation study of a Korean version of the Brief Pain Inventory. Oncology 66(6): 439-444, 2004.

Badia X, Muriel C, Gracia A, Nunez-Olarte JM, Perulero N, Galvez R, Carulla J, Cleeland CS. Validation of the Spanish version of the Brief Pain Inventory in patients with oncological pain [in Spanish]. Med Clin (Barc) 2003; 120(2):52-59.

Klepstad P, Loge JH, Borchgrevink PC, Mendoza TR, Cleeland CS, Kaasa S. The Norwegian Brief Pain Inventory questionnaire: Translation and validation in cancer pain patients. J Pain Symptom Manage 24(5): 517-525, 2002.

Mystakidou K, Mendoza T, Tsilika E, Befon S, Parpa E, Bellos G, Vlahos L, Cleeland C. Greek Brief Pain Inventory: Validation and utility in cancer pain. Oncology 60(1): 35-42, 2001.

Ger LP, Ho ST, Sun WZ, Wang MS, Cleeland CS. Validation of the Brief Pain Inventory in a Taiwanese population. J Pain Symptom Manage 18(5): 316-322, 1999.

Radbruch L, Loick G, Kiencke P, Lindena G, Sabatowski R, Grond S, Lehmann KA, Cleeland CS. Validation of the German version of the Brief Pain Inventory. J Pain Symptom Manage 18(3): 180-187, 1999.

Saxena A, Mendoza T, Cleeland CS. The assessment of cancer pain in north India: the validation of the Hindi Brief Pain Inventory--BPI-H. J Pain Symptom Manage 17(1): 27-41, 1999.

Uki J, Mendoza T, Cleeland CS, Nakamura Y, Takeda F. A brief cancer pain assessment tool in Japanese: the utility of the Japanese Brief Pain Inventory--BPI-J. J Pain Symptom Manage 16(6): 364-373, 1998.

Caraceni A, Mendoza TR, Mencaglia E, Baratella C, Edwards K, Forjaz MJ, Martini C, Serlin RC, De Conno F, Cleeland CS. A validation study of an Italian version of the Brief Pain Inventory (Breve Questionario per la Valutazione del Dolore). Pain 65(1): 87-92, 1996.

Wang XS, Mendoza TR, Gao SZ, Cleeland CS. The Chinese version of the Brief Pain Inventory (BPI-C): Its development and use in a study of cancer pain. Pain 67(2-3): 407-416, 1996.

Cleeland CS, Nakamura Y, Mendoza TR, Edwards KR, Douglas J, Serlin RC. Dimensions of the impact of cancer pain in a four country sample: New information from multidimensional scaling. Pain 1996;67:267-273.

Serlin RC, Mendoza TR, Nakamura Y, Edwards KR, Cleeland CS. When is cancer pain mild moderate or severe? Grading pain severity by its interference with function. Pain 1995;61:277-284.