Reliability and responsiveness of three different pain assessments.

The visual analogue scale (VAS) and ordered categorical scales, i.e. numeric rating scales (NRS), are commonly used in the assessment of pain. However, these scales are bounded by fixed endpoints and thus the range of measurement is limited. The disparity in repeated assessments of perceived pain intensity with the VAS, NRS, and electrical stimulation applied as a matching stimulus was studied in 69 patients (48 women and 21 men, 19-72 years) with chronic nociceptive or neurogenic pain. Responsiveness with transcutaneous electrical nerve stimulation (TENS) using the same measurement procedures was evaluated in the same patients. Comparison of results from the three pain assessments showed that the painmatcher is at least as reliable and responsive as VAS and NRS. None of the three measurements showed evidence for systematic disagreement and had only significant random individual disagreement. They also showed evidence for responsiveness.

[1]  C. Warfield,et al.  The measurement of pain. , 1988, Hospital practice.

[2]  S. Sheather,et al.  Clinical applications of visual analogue scales: a critical review , 1988, Psychological Medicine.

[3]  Lauren J. DeLoach,et al.  The Visual Analog Scale in the Immediate Postoperative Period: Intrasubject Variability and Correlation with a Numeric Scale , 1998, Anesthesia and analgesia.

[4]  J C Grip,et al.  Ordinal scales and foundations of misinference. , 1989, Archives of physical medicine and rehabilitation.

[5]  D. Turk,et al.  Assessment of patients' reporting of pain: an integrated perspective , 1999, The Lancet.

[6]  J M Linacre,et al.  Rasch analysis of Visual Analog Scale measurements before and after treatment of Patellofemoral Pain Syndrome in women. , 1995, Scandinavian journal of rehabilitation medicine.

[7]  C. Robinson,et al.  Prediction and assessment of the severity of post-operative pain and of satisfaction with management , 1998, Pain.

[8]  A. Carlsson.  Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale , 1983, Pain.

[9]  Laurence A. Bradley,et al.  8 – Assessment of Chronic Pain , 1981 .

[10]  J. Atkinson,et al.  Measurement of pain: Patient preference does not confound pain measurement , 1981, Pain.

[11]  S. Braver,et al.  The measurement of clinical pain intensity: a comparison of six methods , 1986, Pain.

[12]  D. Price.  Psychological and neural mechanisms of the affective dimension of pain. , 2000, Science.

[13]  D. Price,et al.  The validation of visual analogue scales as ratio scale measures for chronic and experimental pain , 1983, Pain.

[14]  E. Huskisson.  Measurement of pain. , 1974, Lancet.

[15]  C. Chapman,et al.  Effects of intrasegmental electrical acupuncture on dental pain: Evaluation by threshold estimation and sensory decision theory , 1977, Pain.

[16]  L. Huey,et al.  On the sensitivity of the tourniquet pain test , 1977, Pain.

[17]  E Svensson,et al.  Ordinal invariant measures for individual and group changes in ordered categorical data. , 1998, Statistics in medicine.