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Moreover, if descriptive terms like 'mild', 'moderate', 'severe' or a nu-
merical scale are added to the VAS, one speaks of a Graphic Rating Scale
(GRS) [17]. Pain intensity thus, is determined by measuring the distance
from the lower end of the scale to the mark made by the patient.
b. Verbal Rating Scales (VRS). Similarly to VAS/GRS, Verbal Rating Scales
also consist of two endpoints, and of a set of four-to-six adjectives that are
used to describe different levels of pain (fig. 4), as explained by [17].
Fig. 4. A Verbal Rating Scale
A different form of VRS is the Behavioral Rating Scale where pain level
is described by sentences indicating behavioral activities. Unlike VAS/GRS,
Verbal Rating Scale is usually in the form of a questionnaire, rather than a
straight horizontal line.
c. Numerical Rating Scales (NRS). The last of the tools that are going to be de-
scribed in this work is the NRS, where people are asked to rate their pain in-
tensity from a scale of 0-10 or 0-100 [25]. Zero usually represents “no pain”
whereas the upper limit represents “the worst pain possible”. Fig. 5 shows an
example of a NRS.
Fig. 5. A Numerical Rating Scale
Although the pain assessment tools just described are all considered to be valid,
there seems to be a lot of debate in literature as whether which are reliable for the
purpose intended. Several studies have been conducted in order to prove their reliabil-
ity similar to the one described in [30] review of pain measurement tools. In this study
performed on patients with chronic pain, six different forms of the pain tools
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