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The best-worst scaling enhances assessment of non-oncologic lower limb pain by capturing patient preferences, identifying gaps between clinician and patient goals, and enhancing overall treatment satisfaction.
Non-oncologic lower limb pain continues to impose a substantial burden, limiting function and reducing overall patient well-being. Despite routine use, conventional pain measurement tools often lack the depth required to reflect the complex reality of chronic pain. As precision care and patient involvement gain prominence across global healthcare, the best-worst scaling (BWS) is being recognized as a more discriminating instrument for understanding treatment priorities.
The study sought to assess the state of existing research, summarize core findings, and identify gaps in the application of BWS for evaluating chronic lower limb pain outcomes. The investigators carried out a narrative review, drawing insights from a systematic exploration of PubMed and the Revista Portuguesa de Medicina Geral e Familiar. Their approach incorporated two distinct search pathways: one dedicated to research on chronic non-oncologic lower limb pain and another examining how the BWS has been utilized to capture patient-reported preferences.
The results revealed that, out of 124 studies initially identified, only 16 met the inclusion criteria and were analyzed to evaluate the practical applications, potential benefits, limitations, and broader implications of integrating the BWS into pain assessment and clinical decision-making. BWS emerged as a valuable tool in healthcare research, providing a clearer understanding of patient priorities when navigating treatment options.
Studies investigating its use in chronic lower limb pain (including osteoarthritis), suggested that the scale offered deeper, more representative insights than traditional pain scoring systems. The findings further highlighted that BWS could reveal discrepancies between patient-valued outcomes and clinician-focused goals, emphasizing the importance of preference-aligned treatment planning. At the same time, the review underscored that widescale implementation would require prudent refinement, validation, and evidence-based strategies to ensure reliability and broad clinical adoption.
To sum up, incorporating BWS into routine examination could provide a more precise, patient-centered approach to evaluating non-oncologic lower limb pain and strengthen shared treatment decisions. Further refinement, standardization, and clinical validation were considered essential to fully realize its potential in improving patient outcomes, informing treatment pathways, and advancing evidence-based pain-evaluation practices.
Acta Médica Portuguesa
The Best-Worst Scale in Non-Oncologic Lower Limb Pain
Mariana Isabel Da Silva Fernandes et al.
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