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1. to the ventral forearm by an electronically controlled contact thermode The heat stimili were programmed to last 5 seconds and to present randomly 43 C 45 C 46 C 47 C 48 C 49 C or 51 C A 2 minute trial interval followed each stimulus presentation during which the subject rated the stimulus on 5 scales Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Results reliability Results validity Commentary IC nternal consistency Intercorrelations between the scales were all statistically significant at every temperature p lt 0 001 Cronbach s alpha within each scale across the 7 temperature values VAS 0 88 NRS 0 88 VDS 0 86 VNS 0 88 FPS 0 88 Cronbach s alpha within temperature across the 5 scales 43 C 0 96 45 C 0 96 46 C 0 96 47 C 0 97 48 C 0 97 49 C 0 97 51 C 0 97 E nterrater reliability VAS 93 5 agreement NRS 100 agreement VDS 100 agreement VNS 100 agreement FPS 100 agreement CsV Principal components analysis A one factor model was extracted from the different measurement scales The correlation of each scale to the isolated fact2. 2000 Tamiya et al 2002 Triano McGregor Cramer amp Emde 1993 et d autres patients pr sentant des formes sp cifiques de douleur Crossley Bennell Cowan amp Green 2004 Freeman Smyth Dallam amp Jackson 2001 Gallagher Bijur Latimer amp Silver 2002 Gagliese amp Katz 2003 Par cons quent l utilisation de la VAS comme instrument de mesure pour le management de la douleur peut tre g n ralis e pour une large population de patients Description La VAS est une ligne de 100 mm dont les deux extr mes sont limit s par les termes Aucune douleur et Pire douleur possible L intention est que le patient indique sur la ligne l intensit de la douleur qu il ressent au moment du relev L cart entre le point z ro Aucune douleur et le marquage du patient est ensuite mesur en mm par le dispensateur de soins La version la plus connue de la VAS a une ligne d orientation horizontale bien qu une orientation verticale soit aussi courante pour l valuation de la douleur du patient Il existe de nombreuses variantes a la version originale de la VAS Des diff rences se retrouvent notamment dans la terminologie que l on utilise pour d limiter le point final ex douleur extr me douleur la plus atroce la pr sence de pointill s de s paration sur l chelle et l unit de longueur utilis e cm ou mm Fiabilit La VAS pr sente une haute fiabilit Cela peut tre amplemen
3. Gallagher E J Bijur P E 2 urban emergency Convenience sample of patients with Repeated measures design S Sen Latimer C amp Silver W departments the chief complaint of acute VAS measurements 1 minute apart abdominal pain every 30 minutes over two hours 2002 n 101 Jensen M P Chen C amp Not specified 123 patients who had undergone Repeated measures design Sen Brugger A M knee surgery and 124 women who Baseline measurement with 16 had undergone a laparatomy additional measures up to 24h 2002 n 227 following surgery Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Results reliability Results validity Commentary CrV Concurrent validity A mathematical transformation of the FRS in a numeric value was highly correlated with the VAS r 0 92 There was a significant increase in variability in VAS with increasing values of the FRS p lt 0 05 S ntrarater reliability Sen After completing the VAS at the end of each 30 minute interval patients r 0 99 95 Cl 0 989 to 0 992 were also asked to contrast current pain with their pain at the previous using one of
4. Odds Ratio OR Author Setting Sample Design Reliability Validity year n Bijur P E Silver W amp Two emergency Convenience sample of adults with Repeated measures design S Sen Gallagher E J departments acute pain as a component of their VAS measurements 1 minute apart chief complaint every 30 minutes over two hours 2001 n 69 Pomeroy V M Frames C Nursing homes Stroke patients experiencing shoulder Repeated measures design 3 S Faragher E B Hesketh A among other things pain measures in one week E Hill E Watson P et al n 33 2000 Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Results reliability Results validity Commentary S ntra rater reliability r 0 97 95 CI 0 96 to 0 98 Bland Altman analyses 50 percent of the differences between the repeated VAS scores time 0 and 1 minute later were within 2mm 90 were within 9mm and 95 of the scores were within 16mm of the 100 mm VAS Sen Convergent validity After completing the VAS at the end of each 30 minute interval patients were also asked to contrast current pain wi
5. satisfaction Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Results reliability Results validity Commentary CrV Concurrent validity There were significant moderate interscale correlations in both age groups In the older group on POD 1 the correlations between MPQ and both VAS ratings and between PPI and VAS M failed to reach significance The remaining correlations were significant On POD 2 the only nonsignificant correlation was between VAS M and MPQ The magnitude of the correlations did not differ between the groups except for VAS R and MPQ On both POD 1 p lt 0 05 and POD 2 p lt 0 004 this correlation was lower in older than younger patients CsV Convergent validity On all scales there was a significant decrease in scores with time The amount of morphine self administered also decreased over time in both groups but the decrease POD 1 minus POD 2 was greater in the younger 27 68 22 93 mg than the older 20 51 19 58 mg patients p lt 0 02 S ntra rater reliability VAS Pain at the same day of administration n 47 r 0 84 95 CI 0 78 0 88 Intra rater reliabili
6. Activity r 0 68 Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Author Setting Sample Design Reliability Validity year n Gagliese L amp Katz J Not specified Men scheduled for radical Repeated measures design CrV prostatectomy and who were eligible VAS assessed intensity of pain at CsV 2003 for postoperative patient controlled rest VAS R and in response to a analgesia Two groups younger and standard mobilization exercise older were formed based on a split of VAS M after sitting upright from a the sample at the median age of 62 lying position and taking two years maximal inspirations McGill Pain n 95 Questionnaire MPQ and Present Pain Intensity PPI were compared on postoperative day 1 POD1 and postoperative day 2 POD2 Tamiya N Araki S Ohi G Patients were Female rheumatoid arthritis RA Comparative study S CsV Inagaki K Urano N Hirano W et al 2002 recruited during routine return visits to the clinic of a rheumatoid specialist in Tokyo patients n 145 VAS was compared with affect measurements VAS Anxiety VAS Depression and VAS Life
7. Herrmann F Le The inpatient Elderly who met DSM criteria for Repeated measures design S CrV Lous P Fabjan M Michel J dementia dementia Patients were asked to indicate E P amp Gold G 2005 consultation of the Geneva Geriatric Hospital n 160 their current level of pain on different scales horizontal vertical VAS Faces Pain Scale and Verbal Rating Scale This was repeated 30 minutes later either by the same investigator 50 of the cases or by a different examiner who was blinded to the first assessment Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Results reliability Results validity Commentary S ntra rater reliability horizontal VAS r 0 95 p lt 0 001 Intra rater reliability vertical VAS r 0 94 p lt 0 001 E nterrater reliability horizontal VAS r 0 90 p lt 0 001 Interrater reliability vertical VAS r 0 87 p lt 0 001 CrV Concurrent validity Correlation between horizontal VAS and different scales at first assessment 1 Correlation VAS Verbal Rating Scale r 0 91 p lt 0 001 2 Correlation VAS Faces
8. Med Rehabil 85 815 822 Downie W W Leatham P A Rhind V M Wright V Branco J A amp Anderson J A 1978 Studies with pain rating scales Ann Rheum Dis 37 378 381 Dworkin R H Turk D C Farrar J T Haythornthwaite J A Jensen M P Katz N P et al 2005 Core outcome measures for chronic pain clinical trials IMMPACT recommendations Pain 113 9 19 Freeman K Smyth C Dallam L amp Jackson B 2001 Pain measurement scales a comparison of the visual analogue and faces rating scales in measuring pressure ulcer pain J Wound Ostomy Continence Nurs 28 290 296 Gagliese L amp Katz J 2003 Age differences in postoperative pain are scale dependent a comparison of measures of pain intensity and quality in younger and older surgical patients Pain 103 11 20 Gagliese L Weizblit N Ellis W amp Chan V W 2005 The measurement of postoperative pain a comparison of intensity scales in younger and older surgical patients Pain 117 412 420 Gallagher E J Bijur P E Latimer C amp Silver W 2002 Reliability and validity of a visual analog scale for acute abdominal pain in the ED Am J Emerg Med 20 287 290 Herr K A Mobily P R Kohout F J amp Wagenaar D 1998 Evaluation of the Faces Pain Scale for use with the elderly Clin J Pain 14 29 38 Herr K A Spratt K Mobily P R amp Richardson G 2004 Pain intensity assess
9. Pain Scale r 0 88 p lt 0 001 3 Correlation VAS Doloplus 2 observational pain scale r 0 35 p lt 0 001 Correlation between horizontal VAS and different scales at second assessment 4 Correlation VAS Verbal Rating Scale r 0 85 p lt 0 001 5 Correlation VAS Faces Pain Scale r 0 87 p lt 0 001 6 Correlation VAS Doloplus 2 observational pain scale r 0 36 p lt 0 001 Correlation between vertical VAS and different scales at first assessment 1 Correlation VAS Verbal Rating Scale r 0 89 p lt 0 001 2 Correlation VAS Faces Pain Scale r 0 89 p lt 0 001 3 Correlation VAS Doloplus 2 observational pain scale r 0 40 p lt 0 001 Correlation between vertical VAS and different scales at second assessment 4 Correlation VAS Verbal Rating Scale r 0 89 p lt 0 001 5 Correlation VAS Faces Pain Scale r 0 90 p lt 0 001 6 Correlation VAS Doloplus 2 observational pain scale r 0 39 p lt 0 001 Weak correlations between VAS and Doloplus 2 The authors reported a trend towards better comprehension of the horizontal VAS Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR
10. 5 categorical descriptors much less pain a little less pain about the Bland Altman analyses same pain a little more pain or much more pain Differences in VAS scores 50 percent of the differences between increased linearly as pain descriptors escalated from much less to much the repeated VAS scores time 0 and 1 more pain F 79 4 p lt 0 001 minute later were between 3mm and 2mm 90 were between 8mm and 9mm and 95 of the scores were within 11mm of the 100 mm VAS Sen Repeated measures ANOVA Dependent variables VAS and VRS pre to post treatment difference scores Independent variables time and analgeticum treatment VAS tended to be more sensitive than VRS showing the smallest F values p lt 0 001 Acomposite measure made up of a standardized average of three measures of outcome VAS difference score VRS difference score and a pain relief rating was not more sensitive to treatment effects analgetica than any one measure Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Author Setting Sample Design Reliability Validity year n Pautex S
11. Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Results reliability Results validity Commentary Sen There was a statistically significant difference between VAS scores at time 1 vs time 3 F 53 23 p lt 0 001 and at time 2 vs 3 F 47 84 p lt 0 001 Correlation between VAS at time 1 and VAS at time 2 was high r 0 87 and decreased substantially when measured between VAS at time 2 and VAS at time 3 r 0 26 The Oswestry Low Back Pain Disability Questionnaire and VAS were both more valid and reliable than other instruments for application for treatment of musculoskeletal disorders S ntra rater reliability Participants completed a second set of questionnaires within 7 days of the original assessment but before their first appointment for a treatment session Intra rater reliability VAS U r 0 56 Intra rater reliability VAS W r 0 76 Intra rater reliability VAS activity r 0 83 CsV Convergent validity Measures were completed at baseline and at the conclusion of the 6 week treatment program The change from baseline to final assessment was calculated The mean change scores were moderately correlated with a global rating of change as perceived by the patient A VAS U r 0 67 A VAS W r 0 69 A VAS
12. VAS est un instrument de mesure valide pour l appr ciation de la douleur Plusieurs tudes ont compar des scores VAS de patients avec des scores sur d autres chelles de douleur Benaim et al 2007 Freeman et al 2001 Hicks von Baeyer Spafford Korlaar amp Goodenough 2001 Gagliese et al 2005 Kim amp Buschmann 2006 Mawdsley et al 2002 Pautex et al 2005 Pautex et al 2006 Stinson et al 2006 van Dijk Koot Saad Tibboel amp Passchier 2002 La corr lation plut t importante entre la VAS et d autres chelles de valeur valides confirme la concurrent validity de chelle Afin de v rifier la construct validity de la VAS Gagliese et al 2005 et Herr et al 2004 ont effectu une analyse des principaux composants Dans les deux tudes 1 facteur a t abstrait au d part des scores de douleur sur les diff rents instruments de mesure a un item Des corr lations significatives ont galement t rapport es entre des scores VAS et l administration d analg siques Abu Saad amp Holzemer in Stinson et al 2006 Aradine et al in Stinson et al 2006 Gagliese amp Katz 2003 Tyler et al in Stinson et al 2006 le taux de prot ine C r active Tamiya et al 2002 l intensit de la douleur caus e Herr et al 2004 des observations comportementales chez des patients souffrant de douleurs Koho Aho Watson amp Hurri 2001 La sensitivit de la VAS est confirm e par des tudes a
13. Visual Analogue Scale VAS Plusieurs auteurs depuis 1974 eum de Visual Analogue Scale mesure Abr viation VAS Huskisson E C 1974 Measurement of pain Lancet 2 1127 Auteur 1131 Th me Management des sympt mes de la douleur Objectif Evaluer la douleur chez le patient Population Non sp cifi e Relev Dispensateur de soins Nombre d items 1 item Pr sence du Oui patient requise Localisation de l instrument de http www ndhcri org mesure Objectif Contr le de la douleur chez le patient l aide d un autorapport sur une chelle un item Groupe cible Le groupe cible vis par la Visual Analogue Scale VAS est divers La validit de l instrument de mesure a d j t tudi e chez des enfants adolescents Stinson Kavanagh Yamada Gill amp Stevens 2006 chez des adultes Bijur Silver amp Gallagher 2001 Carey Turpin Smith Whatley amp Haddox 1997 ainsi que chez des personnes g es Carey Turpin Smith Whatley amp Haddox 1997 Mawdsley Moran amp Conniff 2002 Pautex et al 2006 Des tudes valident l utilisation de la VAS pour diverses cat gories de patients telles que les patients en service de chirurgie Gagliese Weizblit Ellis amp Chan 2005 Jensen Chen amp Brugger 2002 les d ments Pautex et al 2005 Pautex et al 2006 les patients souffrant de probl mes musculo squelettiques Mawdsley et al 2002 Pomeroy et al
14. and other outcome measures Chiropractic first time as well as those who had Oswestry Low Back Pain Disability 1993 Center not been seen in outpatient clinic Questionnaire Modifief Zung within the previous 6 months A total Depression Scale Pain Drawing of 145 of 186 completed the final 6 Modified Somatic Perception weeks follow up 41 subjects Questionnaire and Pain Locus of completed only the first follow up Control for use with back pain n 186 patients were administered a prior to clinical evaluation for chief compliant of the patient b immediately after clinical evaluation and before treatment and c 6 weeks later Crossley K M Bennell K L General community 71 persons with patellofemoral pain RCT S CsV Cowan S M amp Green S 2004 and private practice were used to evaluate the VAS validity a subset of 17 persons was used to assess the reliability n 71 The experimental treatment was a physiotherapy intervention quadriceps muscle retraining patellar tape stretching education and the placebo treatment consisted of a sham ultrasound Outcome measures VAS for usual pain VAS U VAS for worst pain VAS W VAS for pain on 6 aggravating activities walking running squatting sitting ascending and decending stairs VAS activity Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV
15. bility and reliability of four pain self assessment scales and correlation with an observational rating scale in hospitalized elderly demented patients J Gerontol A Biol Sci Med Sci 60 524 529 Pautex S Michon A Guedira M Emond H Le Lous P Samaras D et al 2006 Pain in severe dementia self assessment or observational scales J Am Geriatr Soc 54 1040 1045 Pomeroy V M Frames C Faragher E B Hesketh A Hill E Watson P et al 2000 Reliability of a measure of post stroke shoulder pain in patients with and without aphasia and or unilateral spatial neglect Clin Rehabil 14 584 591 Stinson J N Kavanagh T Yamada J Gill N amp Stevens B 2006 Systematic review of the psychometric properties interpretability and feasibility of self report pain intensity measures for use in clinical trials in children and adolescents Pain 125 143 157 Tamiya N Araki S Ohi G Inagaki K Urano N Hirano W et al 2002 Assessment of pain depression and anxiety by visual analogue scale in Japanese women with rheumatoid arthritis Scand J Caring Sci 16 137 141 Triano J J McGregor M Cramer G D amp Emde D L 1993 A comparison of outcome measures for use with back pain patients results of a feasibility study J Manipulative Physiol Ther 16 67 73 van Dijk M Koot H M Saad H H Tibboel D amp Passchier J 2002 Observational visual analog scale in pe
16. ct validity CSV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Results reliability Results validity Commentary CrV Concurrent validity Results indicate that pain intensities by the FPS the NRS and the VAS were not significantly different F 1 00 68 00 2 93 p 0 09 likewise the tools were not different in reporting the intensity of patient s pain The VAS had moderately strong correlation with the FPS r 0 73 p lt 0 001 and the NRS r 0 91 p lt 0 001 Correlation between the VAS and the NRS of the cognitively impaired group r 0 88 p lt 0 001 was weaker than the correlation of the cognitively intact group r 0 92 p lt 0 001 correlation between the FPS and the NRS of the cognitively impaired group r 0 75 p lt 0 001 was slightly stronger than correlation of the cognitively intact group r 0 70 p lt 0 001 Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR
17. diatric pain assessment useful tool or good riddance Clin J Pain 18 310 316 Localisation de l instrument de mesure http www ndhcri org VISUAL ANALOGUE SCALE VAS VERSCHEIDENE AUTEURS SINDS1974 Author Setting Sample Design Reliability Validity year n Pautex S Michon A Geriatrics hospital 129 patients aged 65 and older Repeated measures design S CrV Guedira M Emond H Le and a geriatric hospitalized during a 15 month period Patients were asked to indicate E Lous P Samaras D et al psychiatry service who met DSM criteria for dementia their current level of pain on with a Mini Mental State Examination different scales VAS Faces Pain 2006 score less than 11 and a Clinical Scale and Verbal Rating Scale Dementia Rating of 3 or greater This was repeated 30 minutes later n 129 either by the same investigator 50 of the cases or by a different examiner who was blinded to the first assessment Gagliese L Weizblit N Ellis Toronto General Patients scheduled to receive patient Comparative study the VAS was FV W amp Chan V W Hospital University controlled analgesia following general compared with the Numeric Rating CrV Health Network and surgery Scale NRS the Verbal Descriptor CsV 2005 Mount Sinai n 504 Scale VDS and the pain intensity Hospital Toronto Ontario measures of the McGill Pain Questionnaire MPQ Reliability Stabil
18. e VAS was compared with FRS Hospital Atlanta chronic pain and 20 2 with no pain and NRS 1997 n 267 Mawdsley R H Moran K A An outpatient Elderly with musculoskeletal injury or Repeated measures design E amp Conniff L A setting disorders with pain aged 61 to 84 VAS and NRS measurements 15 n 32 minutes apart 2002 Hicks C L von Baeyer C L Two urban jewelry Children aged 5 to 12 Validation study CrV Spafford P A van K amp Goodenough B 2001 stores n 76 To validate a revised version of the FPS FPS R with 6 faces instead of 7 Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Results reliability Results validity Commentary E nter observer reliability Inter observer reliability between professionals VAS ratings nurses physician or researcher r 0 42 to 0 91 median 0 75 Inter observer reliability between professionals and parents VAS ratings r 0 36 to 0 85 median 0 52 CrV Concurrent validity Correlation coefficients between self reported VAS of children VAS sr and VAS results of observational prof
19. east preferred instrument for future assessments The VAS had the highest proportion of patients making errors p lt 0 005 CrV Concurrent validity Correlation between VAS and VDS and NRS 1 Patients aged gt 60 years r 0 60 0 93 p lt 0 001 2 Patients aged lt 60 years r 0 72 0 91 p lt 0 001 Correlation between VAS and MPQ was lower CsV Principal components analysis A one factor model was extracted from the different measurement scales and accounted for 82 of the total variance in the young group and 85 of the variance in the older group Factor loadings were 0 95 for horizontal VAS and 0 91 for vertical VAS The vertical VAS was associated with lower error rates and greater face validity than the horizontal VAS Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Author Setting Sample Design Reliability Validity year n Freeman K Smyth C Hospital Adults who had one or more stage 1 Comparative study the VAS was CrV Dallam L amp Jackson B to 4 pressure ulcer and had some compared with the Faces Rating ability to explain their pain Scale FRS 2001 experience n 44
20. essionals ranged from 0 23 to 0 85 median 0 53 Correlation coefficients between VAS sr and VAS results of observational parents ranged from 0 46 to 0 83 median 0 70 Correlation VAS results of observers and other pain instruments r 0 42 to 0 86 median 0 68 IC Cronbach s alpha Intercorrelations between 3 scales was a 0 88 Patients selected the FPS as easiest to use 48 6 followed by the NRS 35 3 and the VAS 16 1 S ntra rater reliability NRS r 0 74 Intra rater reliability VAS r 0 92 CrV Concurrent validity A strong positive correlation r 0 93 p lt 0 001 was found between the ratings of pain intensity on the VAS and FPS R The psychometric scale evaluation was conducted using an experimental pain stimulus instead of using clinical pain stimili Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Author Setting Sample Design Reliability Validity year n Triano J J McGregor M The National Patients presenting to the National Repeated measures design Sen Cramer G D amp Emde D L College of College of Chiropractic Center for the VAS
21. ho S Watson P Patients were Patients 45 5 had radiation of pain Comparative study Observations of CsV amp Hurri H referred by the below the level of the knee Other pain behaviour were compared with Social Insurance signs of root compression e g reflex VAS and other outcome measures 2001 Institute to the changes or neurological defences indirect related to pain e g chronic pain were observed in 38 6 of the depression disability management patients programme at n 51 ORTON Rehabilitation Centre in Helsinki Finland Paice J A amp Cohen F L A large tertiary care A convenience sample of 50 adult Comparative study the VAS was CrV 1997 hospital oncological patients with pain n 50 compared with NRS and Simple Descriptor Scale SDS Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CSV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Results reliability Results validity Commentary S ntra rater reliability Test retest evidence for VAS indicated a moderate to strong positive median correlation r 0 70 between pain intensity ratings reported by 5 6 year olds over a two week interval McGrath e
22. ity S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Results reliability Results validity Commentary S ntra rater reliability R 0 98 p lt 0 001 E nterrater reliability R 0 88 p lt 0 001 CrV Concurrent validity Correlation between VAS and different scales at first assessment 1 Correlation VAS Verbal Rating Scale r 0 67 p lt 0 001 2 Correlation VAS Faces Pain Scale r 0 45 p lt 0 001 3 Correlation VAS Doloplus 2 observational pain scale r 0 25 p lt 0 001 Correlation between VAS and different scales at second assessment 4 Correlation VAS Verbal Rating Scale r 0 73 p lt 0 001 5 Correlation VAS Faces Pain Scale r 0 66 p lt 0 001 6 Correlation VAS Doloplus 2 observational pain scale r 0 24 p lt 0 001 Weak correlations between VAS and Doloplus 2 A significant better comprehension of the Verbal Rating Scale VRS and the Faces Pain Scale FPS scale was found This might suggest that the VAS is not the most appropriate pain assessment scale for patients with severe dementia FV Face validity Patients rated the VAS as the least accurate and l
23. ment in older adults use of experimental pain to compare psychometric properties and usability of selected pain scales with younger adults Clin J Pain 20 207 219 Hicks C L von Baeyer C L Spafford P A van K amp Goodenough B 2001 The Faces Pain Scale Revised toward a common metric in pediatric pain measurement Pain 93 173 183 Jensen M P Chen C amp Brugger A M 2002 Postsurgical pain outcome assessment Pain 99 101 109 Jensen M P Engel J M McKearnan K A amp Hoffman A J 2003 Validity of pain intensity assessment in persons with cerebral palsy a comparison of six scales J Pain 4 56 63 Kim E J amp Buschmann M T 2006 Reliability and validity of the Faces Pain Scale with older adults nt J Nurs Stud 43 447 456 Koho P Aho S Watson P amp Hurri H 2001 Assessment of chronic pain behaviour reliability of the method and its relationship with perceived disability physical impairment and function J Rehabil Med 33 128 132 Mawdsley R H Moran K A amp Conniff L A 2002 Reliability of two commonly used pain scales with elderly patients Journal of Geriatric Physical Therapy 25 16 20 Paice J A amp Cohen F L 1997 Validity of a verbally administered numeric rating scale to measure cancer pain intensity Cancer Nurs 20 88 93 Pautex S Herrmann F Le Lous P Fabjan M Michel J P amp Gold G 2005 Feasi
24. mong 71 patients most LHSP preferred FPS 16 32 to VAS 6 32 and VRS 10 32 most RHSP preferred VAS 18 39 to FPS 11 39 and VRS 10 39 The difference was statistically significant p lt 0 05 CrV Concurrent validity The child was asked to estimate his or her current pain on the FPS R followed by either the VAS or the colored analogue scale CAS Each child was randomly assigned to use either the VAS or the CAS Correlations between the FPS R and the CAS and between the FPS R and the VAS were respectively r 0 84 and r 0 92 Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Author Setting Sample Design Reliability Validity year n Kim E J amp Buschmann M T A general hospital 85 older adults with chronic pain i e Comparative study CrV and an oriental a state of pain 2 6 months duration 2006 medical hospital in and for which the cause of the pain Korea could not be removed were recruited n 85 Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Constru
25. or was as follows VAS 0 94 NRS 0 96 VDS 0 95 VNS 0 95 FPS 0 86 Sen Each tool demonstrated significant increases in score associated with increase in temperature p lt 0 001 The VAS had a significant higher failure rate 6 7 in comparison with the NRS VDS VNS and FPS The VNS demonstrated significantly higher levels of pain report than the other 4 scales The psychometric scale evaluation was conducted using an experimental pain stimulus instead of using clinical pain stimili The scales most preferred in order by the total sample NRS 35 3 VDS ce 3 Ke VAS 10 6 Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Author Setting Sample Design Reliability Validity year n Van Dijk M Koot H M Not specified 9 studies were reviewed on reliability Review E CrV Saad H H Tibboel D amp 6 studies were reviewed on validity Passchier J 2002 Carey S J Turpin C Smith Inpatient units of The admitted diagnosis for 39 5 of Comparative study IC J Whatley J amp Haddox D the Crawford Long the sample was acute pain 40 3 with Th
26. orthopedic rheumatological n 4 and other n 8 n 90 FPS FPS R with 6 faces instead of 7 Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Results reliability Results validity Commentary S ntra rater reliability n 33 Kappa coefficients for FPS were 0 74 0 13 and 0 53 0 10 in LHSP and RHSP respectively Kappa coefficients for VRS were 0 39 0 14 and 0 57 0 15 in LHSP and in RHSP respectively ICC for VAS were 0 78 0 46 0 92 and 0 90 0 74 0 96 in LHSP and in RHSP respectively E nterrater reliability n 43 Kappa coefficients for FPS were 0 64 standard error 0 11 and 0 44 0 09 in LHSP and RHSP respectively Kappa coefficients for VRS were 0 46 0 12 and 0 52 0 12 in LHSP and in RHSP respectively ICC for VAS were 0 72 95 Cl 0 44 0 88 and 0 86 0 68 0 94 in LHSP and in RHSP respectively CrV Concurrent validity n 51 LHSP scores on the FPS were highly correlated with VAS r 0 82 p lt 0 001 and with VRS scores r 0 65 p lt 0 01 In the RHSP group correlations were also high r 0 72 0 72 p lt 0 001 respectively A
27. probl mes avec l utilisation de la VAS horizontale en comparaison avec la VAS verticale La VAS verticale est recommand e tant donn que cet instrument de mesure g n rerait moins de relev s erron s et serait plus facilement compr hensible pour les personnes g es Gagliese et al 2005 Convivialit La convivialit de la VAS a t valu e par 33 dispensateurs de soins travaillant dans les services d oncologie m dicale radioth rapie et d oncologie p diatrique de l h pital universitaire de Gand 94 des personnes interrog es constatent que la VAS peut tre relev e en moins de 3 minutes De plus la plupart des dispensateurs de soins sont d avis que la VAS est simple a compl ter 85 et est claire et univoque 91 Le mode d emploi est galement pr cis pour 94 des dispensateurs de soins L valuation de la convivialit de la VAS est donc extr mement positive Notons toutefois que 1 dispensateur de soins sur 2 est d avis qu une formation compl mentaire est requise pour l utilisation de l instrument de mesure Remarques Plusieurs tudes font tat de difficult s chez des patients pour compl ter la VAS Gagliese et al 2005 Herr et al 2004 Paice amp Cohen 1997 Pautex et al 2006 Des comparaisons entre la VAS et la Numeric Rating Scale NRS montrent que l utilisation de cette derni re chelle pose moins de probl mes De plus la NRS b n ficie aussi d une fiabilit validit lev e e
28. t tay l aide de r sultats de diff rentes tudes qui ont d j t r alis es De nombreuses tudes font tat d une intra rater reliability de 0 90 et plus Bijur et al 2001 Mawdsley 2002 Pautex et al 2005 Pautex et al 2006 Quelques tudes mentionnent m me une valeur de 0 99 Gallagher et al 2002 McGrath et al 1985 in Stinson et al 2006 Le nombre d tudes avec une faible intra rater reliability r lt 0 75 est limit Pomeroy et al 2000 Tamiya et al 2002 De plus nous notons que les mesures r p t es sont caract ris es dans ces tudes par de grands intervalles temporels gt 1 jour ce qui explique peut tre la variabilit des scores de douleur la suite de changements dans le v cu de la douleur Des r sultats positifs sont galement g n r s pour l interrater reliability Dans les tudes retrouv es cette corr lation est toujours sup rieure a 0 70 Benaim et al 2007 Herr Spratt Mobily amp Richardson 2004 Pautex et al 2005 Pautex et al 2006 Le coefficient alpha de Cronbach entre la VAS et d autres chelles de mesure un item a t v rifi dans l tude de Herr et al 2004 et dans l tude de Carey et al 1997 La corr lation atteignait respectivement a 0 97 VAS Numeric Rating Scale Verbal Descriptor Scale Verbal Numeric Scale Faces Pain Scale et a 0 88 VAS Faces Rating Scale Numeric Rating Scale Validit La
29. t al in Stinson et al 2006 The strength of the median between session correlation increased in children aged 13 15 years r 0 99 CrV Concurrent validity VAS have demonstrated moderate to strong correlations r 0 63 0 90 with several other pain measures e g Faces Pain Scale and Oucher Beyer amp Aradine in Stinson et al 2006 Tyler et al in Stinson et al 2006 Goodenough et al in Stinson et al 2006 Migdal et al in Stinson et al 2006 Sen VAS have also shown responsivity to change following surgery Tyler et al in Stinson et al 2006 administration of analgesics Abu Saad and Holzemer in Stinson et al 2006 Aradine et al in Stinson et al 2006 Tyler et al in Stinson et al 2006 and following application of a local anesthetic Migdal et al in Stinson et al 2006 CsV Convergent validity VAS scores demonstrated weak correlations with observations of pain behaviour r 0 40 p lt 0 05 CrV Concurrent validity The strong positive correlation between the VAS and the NRS was statistically significant r 0 847 p lt 0 001 VAS was also correlated to SDS r 0 708 p lt 0 001 A majority of subjects 50 preferred the use of the NRS when comparing the three scales used to measure pain intensity Fewer patients preferred the SDS 38 with the VAS chosen least often 12 Eleven subjects 20 in this study were unable to complete the VAS or did so wi
30. t comparable En outre les patients indiquent eux m mes qu ils pr f rent la NRS et d autres chelles de douleur la VAS Carey et al 1997 Dworkin et al 2005 Gagliese et al 2005 Herr et al 2004 Paice amp Cohen 1997 Cela peut indiquer que la NRS est plus indiqu e que la VAS pour l valuation de la douleur Plusieurs tudes de validation recommandent donc la NRS comme tant l instrument le plus ad quat pour l valuation de la douleur Downie et al 1978 Dworkin et al 2005 Jensen et al 2003 Cela doit tre quelque peu nuanc tant donn qu aucune chelle de douleur ne peut tre utilis e pour toutes les formes de douleur ou pour toutes les cat gories d ge R f rences Benaim C Froger J Cazottes C Gueben D Porte M Desnuelle C amp Pelissier J Y 2007 Use of the Faces Pain Scale by left and right hemispheric stroke patients Pain 128 52 58 Bijur P E Silver W amp Gallagher E J 2001 Reliability of the visual analog scale for measurement of acute pain Acad Emerg Med 8 1153 1157 Carey S J Turpin C Smith J Whatley J amp Haddox D 1997 Improving pain management in an acute care setting The Crawford Long Hospital of Emory University experience Orthop Nurs 16 29 36 Crossley K M Bennell K L Cowan S M amp Green S 2004 Analysis of outcome measures for persons with patellofemoral pain which are reliable and valid Arch Phys
31. th great difficulty All subjects were able to complete the NRS and SDS without apparent difficulty Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Author Setting Sample Design Reliability Validity year n Benaim C Froger J 2 rehabilitation Patients who suffered a first unilateral 5 year period prospective study S CrV Cazottes C Gueben D units middle cerebral artery stroke A FPS was compared with vertical E Porte M Desnuelle C amp distinction was made between left and VAS and Verbal Ratings Scale Pelissier J Y right hemispheric stroke patients VRS LHSP RHSP 2007 n 127 Hicks C L von Baeyer C L A children s Children aged 4 to 12 and who were Validation study CrV Spafford P A van K amp hospital hospitalized for surgical treatment in To validate a revised version of the Goodenough B 2001 68 cases 75 including abdominal n 18 ear nose throat n 12 orthopedic n 12 urological n 7 and other n 19 The remaining 22 cases 25 were hospitalized for non surgical painful conditions abdominal n 5 respiratory n 5
32. th their pain at the previous using one of 5 categorical descriptors much less pain a little less pain about the same pain a little more pain or much more pain Differences in VAS scores increased linearly as pain descriptors escalated from much less to much more pain F 79 4 p lt 0 001 S ntra rater reliability r 0 70 E nterrater reliability r 0 79 Examination of the raw data indicated that 27 of the ratings were in exact agreement because all raters gave a score of zero Day to day variation could account for some of the lack of intra rater agreement Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Author Setting Sample Design Reliability Validity year n Herr K A Spratt K Mobily Subjects were 86 younger adults age 25 55 and Repeated measures design IC CsV P R amp Richardson G recruited through 89 older adults age 65 94 Noxious heat stimili were delivered E Sen 2004 college bulletin board displays community faith centers senior citizen centers senior housing and long term facilities n 175
33. ty VAS Pain measured 7 days after the initial measurement n 47 r 0 64 95 CI 0 43 0 78 CsV Convergent validity VAS Pain was moderately positively correlated with VAS Anxiety 0 49 p lt 0 001 and VAS Depression 0 36 p lt 0 001 and moderately negatively correlated with VAS Life satisfaction 0 23 p lt 0 05 VAS Anxiety explained 30 of the variance in pain F 21 1 d f 1 49 p lt 0 001 VAS Depression explained 17 of the variance in VAS Pain F 9 8 d f 1 49 p 0 003 Higher CRP levels were associated with greater pain F 6 09 d f 4 95 p 0 015 Day to day variation could account for some of the lack of intra rater agreement 7 days after the initial measurement Reliability Stability S Internal consistency IC Equivalence E Validity Face validity FV Content validity CtV Criterion validity CrV Construct validity CsV Sensitivity Sen Specificity Sp Positive Predictive Value PPV Negative Predictive Value NPV Receiver Operating Curve ROC Likelihood Ratio LR Odds Ratio OR Author Setting Sample Design Reliability Validity year n Stinson J N Kavanagh T Not appropriate Children aged 3 18 years Review on self report measures of S CrV Yamada J Gill N amp review single item ratings of pain intensity Sen Stevens B for use in clinical trials in children and adolescents 2006 Koho P A
34. vec un repeated measures design Crossley et al 2004 Jensen et al 2002 Ces tudes ont corr l les scores VAS de patients des enregistrements de douleur entre les diff rentes mesures Les volutions de la douleur rapport es par les patients ma douleur a augment ou a diminu taient nettement rattach es aux scores VAS Utilisation de la VAS chez les enfants La VAS a d j t amplement tudi e chez les enfants et fait tat d une bonne validit pour la plupart des enfants partir de l ge de 8 ans Champion et al in Stinson et al 2006 La VAS est toutefois moins indiqu e pour les enfants de moins de 8 La fiabilit de l instrument de mesure diminue dans cette cat gorie d ge Beyer and Aradine in Stinson et al 2006 Shields et al in Stinson et al 2006 La Faces Pain Scale peut repr senter une possible alternative pour la population compos e des enfants ag s de moins de 8 ans Utilisation de la VAS chez les personnes ag es Une tude d montre que les personnes ag es peuvent prouver des difficult s a compl ter et a comprendre la VAS Freeman et al 2001 Herr Mobily Kohout amp Wagenaar 1998 Jensen amp Karoly in Dworkin et al 2005 Pautex et al 2005 Pautex et al 2006 C est particuli rement le cas pour les personnes d un age avanc et les d ments pour lesquels par exemple la Faces Pain Scale ou la Verbal Rating Scale sera plus indiqu e ll est fait tat de plus de
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