Use of the Short-Form McGill Pain Questionnaire as a Diagnostic Tool in Women with Chronic Pelvic Pain

Abstract

Study Objective To estimate the usefulness of the Short-Form McGill Pain Questionnaire (MPQ) pain descriptors in the diagnostic evaluation of chronic pelvic pain. Design Retrospective cohort study (Canadian Task Force classification II-2). Setting University-based center specializing in chronic pelvic pain. Patients Three hundred thirty-one consecutively evaluated women with chronic pelvic pain who had data sufficient for evaluation. Interventions The relationships between MPQ pain descriptors and subsequent diagnoses were evaluated using odds ratios, sensitivity, specificity, and positive and negative predictive values. Measurements and Main Results The most common diagnoses were endometriosis, interstitial cystitis and painful bladder syndrome, and irritable bowel syndrome. Seventy-one percent of the patients had more than one diagnosis. Relative risks for pain descriptors as diagnostic tools for specific diagnoses were most significant, with “cramping” for endometriosis (4.0), “cramping” for interstitial cystitis and painful bladder syndrome (2.0), “sickening” for irritable bowel syndrome (1.5), and “aching” for abdominal myofascial pain syndrome (4.27). Conclusion Several of the MPQ descriptors had high negative predictive values but not high positive predictive values, which suggests that they have diagnostic usefulness in excluding but not predicting pelvic pain–related diagnoses. This was especially the case with cramping as an MPQ descriptor in women with endometriosis. However, overall the MPQ descriptors were not robust as diagnostic tools, which suggests that inclusion of the MPQ descriptors in the evaluation of women with chronic pelvic pain is of limited diagnostic value.