PEG: Pain, Enjoyment, General activity (3-item pain scale)

Brief pain-impact assessment in primary care. Free to use.

pain, primary care 3 items Updated 2026-05-06

Score PEG below → Download printable PDF View source paper (DOI)
What is PEG? PEG (Pain, Enjoyment, General activity (3-item pain scale)) is a validated instrument used to assess brief pain-impact assessment in primary care. It comprises 3 items.

What is PEG?

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.

Clinical context: when PEG is used

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.

Score PEG

Answer all 3 items below to see your PEG score and interpretation.

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How PEG is scored

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.

PEG score interpretation

The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.

Score rangeBandInterpretation
0–3.9MildMild pain impact.
4–6.9ModerateModerate pain impact; consider treatment escalation.
7–10SevereSevere pain impact; multi-modal management.

How to score PEG: worked example

PEG uses a published formula rather than simple summation. Below is a step-by-step calculation with illustrative inputs.

Step 1 — Collect the inputs

InputValue
Pain5
Enjoyment interference5
General activity interference5

Step 2 — Apply the formula

  1. Score each of the 3 items on 0–10 (0 = none, 10 = worst).
  2. PEG = (Pain + Enjoyment + Activity) / 3 = 15 / 3 = 5.0

Step 3 — Read the result

Score = 5Moderate

Use the calculator above with your own values →

Limitations & common pitfalls

How PEG compares to other pain scales

If PEG doesn't fit your context, related instruments in pain include:

ScaleMeasuresItemsTime
NRS PainSelf-reported pain intensity1
LANSSScreen for neuropathic component of pain7
DN4Screen for neuropathic pain10
ODISelf-reported low-back-pain functional disability10
NDISelf-reported neck-pain functional disability10
Oxford Knee ScorePain and function after total knee replacement12
Oxford Hip ScorePain and function after total hip replacement12
LEFSFunction with lower-extremity musculoskeletal disorders20

Frequently asked questions about PEG

What does PEG measure?

PEG (Pain, Enjoyment, General activity (3-item pain scale)) is a validated instrument that assesses brief pain-impact assessment in primary care.

How many items are on PEG?

PEG contains 3 items.

What is a high PEG score?

Scores of 7–10 fall in the "Severe" band. Severe pain impact; multi-modal management.

What is a low PEG score?

Scores of 0–3.9 fall in the "Mild" band. Mild pain impact.

Is PEG free to use?

Yes — PEG is in the public domain and free for clinical, educational, and research use without permission.

What is the source paper for PEG?

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.

Can PEG replace clinical judgment?

No. PEG is a structured assessment aid. A score is one input alongside history, examination, and clinical context. Treatment decisions should never rest on a screening score alone.

References & validation

PEG is supported by the following peer-reviewed sources: