Assessment of subjective appetite sensations in hemodialysis patients. Agreement and feasibility between traditional paper and pen and a novel electronic appetite rating system

Zabel, Rachel; Ash, Susan; Bauer, Judy; King, Neil

doi:10.1016/j.appet.2008.10.010

Cited by 12 publications

(11 citation statements)

References 16 publications

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“…Zabel et al . have previously shown that the mean VAS score reported by patients receiving dialysis with poor appetite is ≤50mm, whereas the mean VAS score reported by patients receiving HD with good appetite is >50 mm (9). Therefore, we defined a VAS score ≤50mm as indicative of anorexia.…”

Section: Methodsmentioning

confidence: 99%

Validating Appetite Assessment Tools Among Patients Receiving Hemodialysis

Molfino

Kaysen

Chertow

et al. 2016

Journal of Renal Nutrition

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Objective To test the performance of appetite assessment tools among patients receiving hemodialysis. Design Cross-sectional. Setting Seven dialysis facilities in Northern California. Subjects 221 patients receiving hemodialysis. Intervention We assessed five appetite assessment tools [self-assessment of appetite, subjective assessment of appetite, visual analogue scale (VAS), Functional Assessment of Anorexia/Cachexia Therapy (FAACT) score and the Anorexia Questionnaire (AQ)]. Main outcome measures Reported food intake, normalized protein catabolic rate (nPCR), and change in body weight were used as criterion measures, and we assessed associations among the appetite tools and biomarkers associated with nutrition and inflammation. Patients were asked to report their appetite and the percentage of food eaten (from 0% to 100%) during the last meal compared to usual intake. Results Fifty-eight (26%) patients reported food intake ≤50% (defined as poor appetite). The prevalence of anorexia was 12% by self-assessment of appetite, 6% by subjective assessment of appetite, 24% by VAS, 17% by FAACT score, and 12% by AQ. All tools were significantly associated with food intake ≤50% (p<0.001), except self-assessment of appetite. The FAACT score and the VAS had the strongest association with food intake ≤50% (c-statistic 0.80 and 0.76). Patients with food intake ≤50% reported weight loss more frequently than patients without low intake (36% vs 22%) and weight gain less frequently (19% vs 35%; p=0.03). nPCR was lower among anorexic patients based on the VAS (1.1 ± 0.3 vs 1.2 ± 0.3, p=0.03). Ln IL-6 correlated inversely with food intake (p=0.03), but neither IL-6 nor CRP correlated with any of the appetite tools. Furthermore, only the self-assessment of appetite was significantly associated with serum albumin (p=0.02), prealbumin (p=0.02) and adiponectin concentrations (p=0.03). Conclusions Alternative appetite assessment tools yielded widely different estimates of the prevalence of anorexia in hemodialysis. When considering self-reported food intake as the criterion standard for anorexia, the FAACT score and VAS discriminated patients reasonably well.

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Section: Methodsmentioning

confidence: 99%

Validating Appetite Assessment Tools Among Patients Receiving Hemodialysis

Molfino

Kaysen

Chertow

et al. 2016

Journal of Renal Nutrition

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“…The Apple Newton electronic appetite rating system was determined to be as sensitive and reliable as the paper method [39]. Other studies support the use of electronic versions of the VAS for appetite assessment; however, although no superiority was found in terms of validity, it was highlighted that data are not interchangeable between electronic and paper versions [40][41][42]. Another study compared eVAS, eNRS, and the electronic version of the Roland-Morris Disability Questionnaire in patients with low back pain [43] and concluded they were comparable with their paper versions.…”

Section: Principal Findingsmentioning

confidence: 99%

Validation of an Electronic Visual Analog Scale mHealth Tool for Acute Pain Assessment: Prospective Cross-Sectional Study

Escalona-Marfil¹,

Coda²,

Ruiz-Moreno³

et al. 2020

J Med Internet Res

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Background Accurate measurement of pain is required to improve its management and in research. The visual analog scale (VAS) on paper format has been shown to be an accurate, valid, reliable, and reproducible way to measure pain intensity. However, some limitations should be considered, some of which can be implemented with the introduction of an electronic VAS version, suitable to be used both in a tablet and a smartphone. Objective This study aimed to validate a new method of recording pain level by comparing the traditional paper VAS with the pain level module on the newly designed Interactive Clinics app. Methods A prospective observational cross-sectional study was designed. The sample consisted of 102 participants aged 18 to 65 years. A Force Dial FDK 20 algometer (Wagner Instruments) was employed to induce mild pressure symptoms on the participants’ thumbs. Pain was measured using a paper VAS (10 cm line) and the app. Results Intermethod reliability estimated by ICC(3,1) was 0.86 with a 95% confidence interval of 0.81 to 0.90, indicating good reliability. Intramethod reliability estimated by ICCa(3,1) was 0.86 with a 95% confidence interval of 0.81 to 0.90, also indicating good reliability. Bland-Altman analysis showed a difference of 0.175 (0.49), and limits of agreement ranged from –0.79 to 1.14. Conclusions The pain level module on the app is highly reliable and interchangeable with the paper VAS version. This tool could potentially help clinicians and researchers precisely assess pain in a simple, economic way with the use of a ubiquitous technology.

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“…The use of EARS was later compared to P&P in a clinical population of haemodialysis patients. For all questions, there was a bias towards lower scores on the EARS than P&P. Due to the unsystematic pattern of variation in the data and the high standard deviations giving wide limits of agreement, these factors suggest that there is limited amount of agreement between the methods and they therefore should not be used interchangeably [9]. …”

Section: Introductionmentioning

confidence: 99%

Validation of a new hand-held electronic data capture method for continuous monitoring of subjective appetite sensations

Gibbons

Caudwell

Finlayson

et al. 2011

Int J Behav Nutr Phys Act

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BackgroundWhen large scale trials are investigating the effects of interventions on appetite, it is paramount to efficiently monitor large amounts of human data. The original hand-held Electronic Appetite Ratings System (EARS) was designed to facilitate the administering and data management of visual analogue scales (VAS) of subjective appetite sensations. The purpose of this study was to validate a novel hand-held method (EARS II (HP® iPAQ)) against the standard Pen and Paper (P&P) method and the previously validated EARS.MethodsTwelve participants (5 male, 7 female, aged 18-40) were involved in a fully repeated measures design. Participants were randomly assigned in a crossover design, to either high fat (>48% fat) or low fat (<28% fat) meal days, one week apart and completed ratings using the three data capture methods ordered according to Latin Square. The first set of appetite sensations was completed in a fasted state, immediately before a fixed breakfast. Thereafter, appetite sensations were completed every thirty minutes for 4h. An ad libitum lunch was provided immediately before completing a final set of appetite sensations.ResultsRepeated measures ANOVAs were conducted for ratings of hunger, fullness and desire to eat. There were no significant differences between P&P compared with either EARS or EARS II (p > 0.05). Correlation coefficients between P&P and EARS II, controlling for age and gender, were performed on Area Under the Curve ratings. R2 for Hunger (0.89), Fullness (0.96) and Desire to Eat (0.95) were statistically significant (p < 0.05).ConclusionsEARS II was sensitive to the impact of a meal and recovery of appetite during the postprandial period and is therefore an effective device for monitoring appetite sensations. This study provides evidence and support for further validation of the novel EARS II method for monitoring appetite sensations during large scale studies. The added versatility means that future uses of the system provides the potential to monitor a range of other behavioural and physiological measures often important in clinical and free living trials.This study was registered as a clinical trial by Current Controlled Trials (Registration Number - ISRCTN47291569).

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Assessment of subjective appetite sensations in hemodialysis patients. Agreement and feasibility between traditional paper and pen and a novel electronic appetite rating system

Cited by 12 publications

References 16 publications

Validating Appetite Assessment Tools Among Patients Receiving Hemodialysis

Validating Appetite Assessment Tools Among Patients Receiving Hemodialysis

Validation of an Electronic Visual Analog Scale mHealth Tool for Acute Pain Assessment: Prospective Cross-Sectional Study

Validation of a new hand-held electronic data capture method for continuous monitoring of subjective appetite sensations

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