**4.1 International Association for the Study of Pain (IASP)- Assessment Tool for Chronic Pain Taxonomy**

It is a symptom sign-based type of deducing the effects of chronic pain in the patient. It is the list of diseases that provide information and classification of pain. Studies on the basis of the location of occurrence the pain, where it is present in the body. Next comes how the patient feels the pain like it is pinching, radiating or may be flickering in nature or does it change as time passes. This helps the clinical person to deduce the type of pain whether neuropathic or nociceptive and also possible organ system that is affected by the pain by deducing if it is visceral or somatic. The last consideration taken is the intensity of the pain [3, 14]. To extract this information, the patient is asked to fill up a questionnaire such as the McGill pain questionnaire which deals with [7, 14]. The problem with such classification of pain is that it is not predictive in similar aspects to TNM which is predictive and can give an idea on how to plan the treatment [3, 6]. Due to much-received criticism, changes were done in 2011 namely, the International Classification of Disease 11th revision (ICD -11) was for chronic pain groups such as chronic cancer pain involving the use of visceral and neuropathic pain and also adding continuous pain and episodic pain (pain that comes and goes) [2].

The IASP classification of chronic pain is done by using these following groups/ domains

Domain 1-The site where the pain occurs Domain 2-Organ systems that get affected due to pain Domain 3-Temporal characteristics deal with the frequency of pain Domain 4-Intensity of the pain and time passed since its onset Domain 5-Pain etiology [3].

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*Assessment and Management of Pain in Palliative Care DOI: http://dx.doi.org/10.5772/intechopen.96676*

It is a numerical-based scale for characterizing and for running prognostic assessment of the condition and it is more predictive as compared to the previous ones. It is based on the scores ranging from 0 to 17, where the higher the scoring on this scale the good/better the prognosis and better chances of pain relief. Hence, this is a very useful tool in determining poor prognostics amongst patients [2]. This scaling has added features compared to IASP assessment for

Where scaling for worst pain is given from 1 to10, for emotional well-being is judged by using Functional Assessment of Cancer Therapy (FACT-G) and the daily opioid dose is monitored for greater than 60 mg consumption as its higher levels of it will make it difficult to control pain and person seems to be more tolerant [3].

To improve on the IASP system of classification for chronic pain, there is a better versed and more widely accepted method of classification called ECS-CP (Edmonton Classification System for Cancer Pain) also is incorporated in the multisite of European Palliative Care Research Collaborative (EPCRC) [3, 4]. It is a more rigorous and user-friendly system of pain classification compared to the previous iterations for classifying pain. Additional descriptive features for pain classification are also incorporated such as the patient's emotional wellbeing. Other than this it incorporates seven components to evaluate the patient as suggested by

Hence it is implied that this is better for further prognosis and pain treatment as this not only keeps check on the emotional/psychological distress but also considers the patient history of having difficulties in the same area or maybe similar types of pain [2, 4, 37]. Also, to be noted that it also checks whether if there is any case of taking opioids and if due to pain there is any cognitive impairment in the concerned patient though their involvement is still debated in the process of pain assessment in the newer version of this model. This method of assessment and prognosis of pain has widely been reviewed and validated in many studies and there is still

ECS-CP questionnaire categories are further dived into subcategories such as the understanding mechanism of pain it can be divided into the following subcategories (**Table 1**) [4]. These can be denoted by a letter such as N for the

**4.2 Cancer pain prognostics scale**

Domain 1-Worst of pain

Domain 3- Pain characteristics

Domain 1-Mechanism of pain Domain 2- Characteristics Domain 3- Cognitive function Domain 4- Previous opioid use Domain 5-Psychological distress

Domain 7-History of such related pain [2, 4, 37].

Domain 6- Tolerance

improvement going on.

Domain 2- Emotional well-being of the patient

**4.3 Edmonton classification system for cancer pain (ECS-CP)**

Domain 4- Daily opioid consumption [3].

pain such as

Bruera E.[4]:
