Patients (N = 198) and their physicians (N = 48) rated the patients’ pain from 0 to 10 using both VAS and VNRS, both at arrival at and on discharge from the ED.
The ratings obtained by VAS and VNRS were highly correlated, for both patients and physicians. The Bland–Altman analysis indicated for the patients 95 % of the differences between VNRS and VAS ratings were between −2.18 and 1.43 and for the physicians 95 % of the differences between the two scales were between −0.80 and 0.67.
Systematic differences between the scores on VRS and VAS were small. In addition, VNRS is easier and quicker to administer and more patients are able to use it.
Estimation of pain intensity in emergency medicine: A v... Pain |
Pain, In Press, Corrected Proof, Available online 24 March 2008 Raoul Daoust, Pierre Beaulieu, Christiane Manzini, Jean-Marc Chauny, Gilles Lavigne Abstract This study was designed to estimate the validity of an 11-point verbal numerical rating scale (VNRS) and a 100 unit (U) plasticized visual analogue scale (VASp) using a 100 mm paper visual analogue scale (VAS) as a gold standard, to recommend the best method of reporting the intensity of acute pain in an emergency department (ED). A convenience sample of 1176 patients with acute pain were recruited in the ED of a teaching hospital. Patients >18 years and able to use the different scales were included. Scales were presented randomly. Results were converted to a 0–100 U scale and validity was quantified using the Bland–Altman method and the intra-class correlation (ICC). The limits of acceptability were previously set for the limits of agreement at ±20 U, with a constant bias. The Bland–Altman method revealed a small bias of –4 U for the VNRS and +1 U for VASp. However, the bias of the VNRS varied with the intensity of pain from −10 to +1 U. The limits of agreement between the VNRS&VAS and the VASp&VAS were −25; +17 U and −17; +18 U, respectively. The ICC was excellent between the VNRS&VAS (0.88) and the VASp&VAS (0.92). In conclusion, the VASp has a small bias, acceptable limits of agreement and an excellent intra-class correlation. It is probably a valid tool to estimate acute pain in the ED. However, the VNRS is less valid in that context because of its wide limits of agreement and variable bias (mainly in lower scores). |
Simple pain rating scales hide complex idiosyncratic me... Pain |
Pain, Volume 85, Issue 3, 1 April 2000, Pages 457-463 Amanda C. de C. Williams, Huw Talfryn Oakley Davies, Yasmin Chadury Abstract Assumptions of reliability and consistency of self-report of pain by patients using visual analogue scales (VAS) and numerical rating scales (NRS) are based on narrow considerations of possible sources of error. This study examined patients’ use of VASs and NRSs, by their own description, with particular attention to rating of multiple pains, of different dimensions of pain, and of interpretation and use of lower and upper endpoints and increments on the scales. These have implications for the approximation of the scales to psychometric requirements. An interview developed from a small pilot project was given to 78 volunteer chronic pain patients embarking on a pain management course, and consisted of both forced choice questions and free response. Data are described with reference to lack of concordance between patients and of consistency within patients; responses suggested that ratings incorporate multiple partially differentiated dimensions of pain, with particular importance placed on function or mobility. Labels assigned to scale endpoints by researchers, whether lexical or numerical, appeared to affect their use; however, covert relabelling of scale points was revealed in free response. The action of arriving at a rating is better conceptualised as an attempt to construct meaning, influenced by and with reference to a range of internal and external factors and private meanings, rather than as a task of matching a distance or number to a discrete internal stimulus. |
View More Related Articles |
How patients and physicians rate patients’ pain in a French emergency department using a verbally administered numerical rating scale and a visual analog scale