How to ask about patient satisfaction? The visual analogue scale is less vulnerable to confounding factors and ceiling effect than a symmetric Likert scale

Voutilainen, Ari; Pitkäaho, Taina; Kvist, Tarja; Vehviläinen‐Julkunen, Katri

doi:10.1111/jan.12875

Cited by 285 publications

(235 citation statements)

References 49 publications

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“…The Likert scale is a form of NS, and it typically has five to seven response levels . In a study with respect to how to determine patient satisfaction, Voutilainen et al demonstrated that the VAS was less vulnerable to confounding factors and ceiling effect than a symmetric Likert scale. The ceiling effect is a measurement limitation that is observed when the majority of participants reach the maximum or near maximum score .…”

Section: Discussionmentioning

confidence: 99%

Esthetic Evaluation of Implant‐Supported Single Crowns: The Implant Restoration Esthetic Index and Patient Perception

Cheng

et al. 2017

Journal of Prosthodontics

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Section: Discussionmentioning

confidence: 99%

Esthetic Evaluation of Implant‐Supported Single Crowns: The Implant Restoration Esthetic Index and Patient Perception

Cheng

et al. 2017

Journal of Prosthodontics

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“…The interventions did not improve patient satisfaction. Despite the use of visual analog scales to prevent ceiling effects , satisfaction was generally high and apparently independent of the oncologist's performance. The interventions also did not prevent decisional conflict.…”

Section: Discussionmentioning

confidence: 96%

Effect of a Skills Training for Oncologists and a Patient Communication Aid on Shared Decision Making About Palliative Systemic Treatment: A Randomized Clinical Trial

et al. 2019

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Background Palliative systematic treatment offers uncertain and often limited benefits, and the burden can be high. Hence, treatment decisions require shared decision making (SDM). This trial examined the independent and combined effect of an oncologist training and a patient communication aid on SDM. Methods In this multicenter randomized controlled trial with four parallel arms (2016–2018), oncologists (n = 31) were randomized to receive SDM communication skills training or not. The training consisted of a reader, two group sessions, a booster session, and a consultation room tool (10 hours). Patients (n = 194) with advanced cancer were randomized to receive a patient communication aid or not. The aid consisted of education on SDM, a question prompt list, and a value clarification exercise. The primary outcome was observed SDM as rated by blinded observers from audio‐recorded consultations. Secondary outcomes included patient‐reported SDM, patient and oncologist satisfaction, patients’ decisional conflict, patient quality of life 3 months after consultation, consultation duration, and the decision made. Results The oncologist training had a large positive effect on observed SDM (Cohen's d = 1.12) and on patient‐reported SDM (d = 0.73). The patient communication aid did not improve SDM. The combination of interventions did not add to the effect of training oncologists only. The interventions affected neither patient nor oncologist satisfaction with the consultation nor patients’ decisional conflict, quality of life, consultation duration, or the decision made. Conclusion Training medical oncologists in SDM about palliative systemic treatment improves both observed and patient‐reported SDM. A patient communication aid does not. The incorporation of skills training in (continuing) educational programs for medical oncologists is likely to stimulate the widely advocated uptake of shared decision making in clinical practice. Trial registration. Netherlands Trial Registry NTR 5489. Implications for Practice Treatment for advanced cancer offers uncertain and often small benefits, and the burden can be high. Hence, treatment decisions require shared decision making (SDM). SDM is increasingly advocated for ethical reasons and for its beneficial effect on patient outcomes. Few initiatives to stimulate SDM are evaluated in robust designs. This randomized controlled trial shows that training medical oncologists improves both observed and patient‐reported SDM in clinical encounters (n = 194). A preconsultation communication aid for patients did not add to the effect of training oncologists. SDM training effectively changes oncologists’ practice and should be implemented in (continuing) educational programs.

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“…The slider also suffered higher rates of non‐completion and longer completion times compared to the two other response methods. These drawbacks of sliders are in contrast to the outcomes of using the paper‐based VASs providing no difference or a quicker response time compared with the Likert‐type scales reviewed in the previous section (Funke & Reips, ; Voutilainen et al., ).…”

Section: Research Findings On Benefits and Drawbacks Of Using Continumentioning

confidence: 96%

“…While Funke and Reips () found no significant difference in response time between the use of 5‐point scales and VASs in a web survey, a study conducted in Finland by Voutilainen, Pitkäaho, Kvist, and Vehviläinen‐Julkunen () showed positive outcomes of using a paper‐based VAS. When patients (n = 150) responded to a 5‐point Likert scale and a VAS on an 80‐mm line to express their patient satisfaction before hospital discharge, their response time with a VAS was 28% (or three and a half minutes) faster.…”

Section: Research Findings On Benefits and Drawbacks Of Using Continumentioning

confidence: 98%

“…With the benefits reviewed in these studies, continuous rating scales such as VASs and sliders are frequently used in healthcare and the social sciences—for example, in tinnitus, endometriosis pain treatment, and orthopedics studies (Adamchic et al., ; Bourdel et al., ; Wall et al., ); in measuring happiness and patient satisfaction (Studer, ; Voutilainen et al., ); and in linguistics (Munson, Schellinger, & Edwards, ). Researchers in these studies found paper‐ or web‐based VASs or sliders to be reliable measurement instruments, and recommended them over 5‐, 7‐, or 10‐point discrete rating scales.…”

Section: Research Findings On Benefits and Drawbacks Of Using Continumentioning

confidence: 99%

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Evidence-Based Survey Design: The Use of Continuous Rating Scales in Surveys

Chyung

Swanson²,

Roberts³

et al. 2018

Perf. Improv.

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When practitioners and researchers develop structured surveys, they may use Likert‐type discrete rating scales or continuous rating scales. When administering surveys via the web, it is important to assess the value of using continuous rating scales such as visual analog scales (VASs) or sliders. Our close examination of the literature on the effectiveness of the two types of rating scales showed both benefits and drawbacks. Many studies recommended against using sliders due to functional difficulties that cause low response rates.

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How to ask about patient satisfaction? The visual analogue scale is less vulnerable to confounding factors and ceiling effect than a symmetric Likert scale

Abstract: The present results supported the use of visual analogue scale rather than Likert scaling in patient satisfaction surveys and stressed the need to account for as many potential confounding factors as possible.

Cited by 285 publications

References 49 publications

Esthetic Evaluation of Implant‐Supported Single Crowns: The Implant Restoration Esthetic Index and Patient Perception

Esthetic Evaluation of Implant‐Supported Single Crowns: The Implant Restoration Esthetic Index and Patient Perception

Effect of a Skills Training for Oncologists and a Patient Communication Aid on Shared Decision Making About Palliative Systemic Treatment: A Randomized Clinical Trial

Evidence-Based Survey Design: The Use of Continuous Rating Scales in Surveys

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