Endpoint Outcomes continues to work on writing up our research project on qualitative research in rating scales. As part of this research we conducted over 400 in-house interviews with patients with a variety of chronic medical conditions. One of the questions we were interested in examining was the ability of patients to identify their abdomen. Current FDA guidance in the area of Irritable Bowel Syndrome (http://www.fda.gov/downloads/Drugs/Guidances/UCM205269.pdf) recommends evaluating pain intensity using an 11-point numeric rating scale that asks patients to rate their daily worst abdominal pain over the past 24-hours. Patients in our study were provided a diagram of a body and asked to circle the area they felt represented the abdomen. Ninety eight per cent of patients circled at least one part of the abdomen; only 8 participants (1.9%) circled something exclusively outside the abdomen, or nothing at all. Participants most commonly circled at least one portion of the middle (89.8%) and/or lower (92.2%) abdomen. 205 participants (49.9%) circled the median and lower abdomen only. 73 participants (17.8%) circled an area inclusive of at least a portion of all nine regions of the abdomen. These findings suggest that when patients are asked about their abdomen they are primarily thinking about the lower abdomen. Questions that refer to the abdomen in PRO measures in gastrointestinal diseases (GI) will probably work best in lower GI disorders and will not work well in upper GI diseases.