Our objective was to evaluate a new electronic visual analogue scale (VAS) system for logging subjective motivation to eat ratings. In total, 10 men and 10 women completed both electronic and traditional pen and paper versions of the questionnaire every hour of the waking day. Subjects consumed a standard medium-fat diet, which was fixed at 1.6 Á BMR. Correlation coefficients for scores obtained by both methods were significant for all questions, with R 2 values ranging from 67 to 87%. However, Bland and Altman plots and paired t-tests identified significant bias between the two methods for five of the nine individual questions. These were questions that tended to be scored more towards the ends of the VAS. The new electronic VAS produces comparable, but not interchangeable, results to the traditional pen and paper method in the study of appetite and mood, while offering advantages of improved reliability in data collection. ( Keywords: visual analogue scales; palmtop computers; electronic data; appetite Visual analogue scales (VAS) have been used in the clinical setting to assess subjective sensations such as pain (Jamison et al., 2001) and quality of life (Nishiyama et al., 2000), and are used extensively to track subjective feelings of motivation to eat (Stubbs et al., 2000). This technique has provided additional insights into the effects of dietary (Stubbs et al., 1996) and exercise (King et al., 1997) interventions, that are not always apparent from direct measures of food intake . Typically, VAS employ the 'pen and paper' (P&P) method where 100 mm lines represent the continuum of the subjective feeling to be rated. Recently, the increasing cost-effectiveness and improved reliability of hand-held computers has encouraged the development of portable electronic VAS systems (Delargy et al., 1996;Jamison et al., 2002;Giffin et al., 2003). We have recently developed our Apple Newton(R)-based system (Stratton et al., 1998) to make use of contemporary Palm(R)-based handheld computers. As the two computer systems differ, for example in screen size and therefore VAS line length, this study was conducted to validate the new electronic appetite rating system (EARS) against the traditional P&P method in free-living subjects. European Journal of Clinical NutritionIn total, 10 male and 10 female subjects (mean (s.d.) age 37(13) and 32(9) years, BMI 25(4) and 20(7) kg Á m À2 , respectively) were each studied on two occasions, separated by 7-days, and each lasting 24-h. Basal metabolic rate (BMR) was measured by indirect calorimetry (Deltatrac II MBM -200, Datex-Ohmeda, Helsinki, Finland) before the study. On each measurement day, subjects were provided with a fixed maintenance diet (40:47:13% energy from fat, CHO and protein, respectively) calculated at 1.6 Á BMR. This comprised of three preprepared, isoenergetic, meals.Subjects completed P&P and EARS questionnaires immediately one after the other to log subjective motivation to eat and mood each hour, during waking hours. On one test day subjects completed the EARS then...
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