Brief pain-impact assessment in primary care. Free to use.
PEG (Pain, Enjoyment, General activity (3-item pain scale)) is a validated clinical instrument used to assess brief pain-impact assessment in primary care. The instrument contains 3 items.
Source / attribution: Krebs EE et al. J Gen Intern Med. 2009;24(6):733-738.
The instrument's primary construct — brief pain-impact assessment in primary care — is operationalized through a fixed set of items, each with a defined response format. This standardisation is what allows PEG scores to be compared meaningfully across clinicians, sites, and studies.
Like all screening or assessment instruments, PEG is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.
Answer all 3 items below to see your PEG score and interpretation.
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PEG uses a published formula (peg) rather than simple summation. The formula and its inputs are visible in our open-source scoring engine.
Scoring notes: PEG = mean of three items; range 0–10.
The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.
| Score range | Band | Interpretation |
|---|---|---|
| 0–3.9 | Mild | Mild pain impact. |
| 4–6.9 | Moderate | Moderate pain impact; consider treatment escalation. |
| 7–10 | Severe | Severe pain impact; multi-modal management. |
PEG uses a published formula rather than simple summation. Below is a step-by-step calculation with illustrative inputs.
| Input | Value |
|---|---|
| Pain | 5 |
| Enjoyment interference | 5 |
| General activity interference | 5 |
Score = 5 → Moderate
If PEG doesn't fit your context, related instruments in pain include:
| Scale | Measures | Items | Time |
|---|---|---|---|
| NRS Pain | Self-reported pain intensity | 1 | — |
| LANSS | Screen for neuropathic component of pain | 7 | — |
| DN4 | Screen for neuropathic pain | 10 | — |
| ODI | Self-reported low-back-pain functional disability | 10 | — |
| NDI | Self-reported neck-pain functional disability | 10 | — |
| Oxford Knee Score | Pain and function after total knee replacement | 12 | — |
| Oxford Hip Score | Pain and function after total hip replacement | 12 | — |
| LEFS | Function with lower-extremity musculoskeletal disorders | 20 | — |
PEG (Pain, Enjoyment, General activity (3-item pain scale)) is a validated instrument that assesses brief pain-impact assessment in primary care. It is designed for clinicians, medical students, evidence-synthesis researchers. The 3 items are combined to produce a total score.
PEG contains 3 items. Items feed into a scoring formula that produces the total. Scores run from 0 to 10, grouped into 3 interpretation bands from ‘Mild’ up to ‘Severe’.
On the PEG (total score 0–10), scores of 7–10 fall in the ‘Severe’ band — interpreted as: Severe pain impact; multi-modal management. The full ladder is: 0–3.9 — Mild: Mild pain impact.; 4–6.9 — Moderate: Moderate pain impact; consider treatment escalation.; 7–10 — Severe: Severe pain impact; multi-modal management. A higher score reflects a more severe presentation, and crossing a cutoff is a prompt to step up assessment or care — but these bands are screening thresholds, not diagnoses.
Scores of 0–3.9 fall in the ‘Mild’ band: Mild pain impact. A low score is reassuring but does not by itself rule out the underlying condition — if symptoms or clinical suspicion persist, reassess over time or use a complementary evaluation rather than relying on the number alone.
Yes — PEG is in the public domain and free for clinical, educational, and research use without permission. You can use this calculator and the scale itself freely; if you publish results or reproduce the scale, cite the original source paper.
Krebs EE et al. Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference. J Gen Intern Med. 2009;24(6):733-738. This is the original publication for the PEG — the reference to cite when reporting results.
No. PEG is a structured assessment aid, not a diagnostic test. Its proper role is clinical assessment of brief pain-impact assessment in primary care — it standardizes assessment and flags who needs closer evaluation, but the result must be weighed alongside history, examination, and clinical context. When a score conflicts with your clinical impression, clinical judgment takes precedence; treatment decisions should never rest on a screening score alone.
PEG is supported by the following peer-reviewed sources: