Test–retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain

Abstract

ObjectiveSeveral scales are commonly used for assessing pain intensity. Among them, the numerical rating scale (NRS), visual analog scale (VAS), and verbal rating scale (VRS) are often used in clinical practice. However, no study has performed psychometric analyses of their reliability and validity in the measurement of osteoarthritic (OA) pain. Therefore, the present study examined the test–retest reliability, validity, and minimum detectable change (MDC) of the VAS, NRS, and VRS for the measurement of OA knee pain. In addition, the correlations of VAS, NRS, and VRS with demographic variables were evaluated.MethodsThe study included 121 subjects (65 women, 56 men; aged 40–80 years) with OA of the knee. Test–retest reliability of the VAS, NRS, and VRS was assessed during two consecutive visits in a 24 h interval. The validity was tested using Pearson’s correlation coefficients between the baseline scores of VAS, NRS, and VRS and the demographic variables (age, body mass index [BMI], sex, and OA grade). The standard error of measurement (SEM) and the MDC were calculated to assess statistically meaningful changes.ResultsThe intraclass correlation coefficients of the VAS, NRS, and VRS were 0.97, 0.95, and 0.93, respectively. VAS, NRS, and VRS were significantly related to demographic variables (age, BMI, sex, and OA grade). The SEM of VAS, NRS, and VRS was 0.03, 0.48, and 0.21, respectively. The MDC of VAS, NRS, and VRS was 0.08, 1.33, and 0.58, respectively.ConclusionAll the three scales had excellent test–retest reliability. However, the VAS was the most reliable, with the smallest errors in the measurement of OA knee pain.

The Extent of Pain Is Associated With Signs of Central Sensitization in Patients With Hip Osteoarthritis

“…Patients are then graded as having chronic pain grade I (low disability, low pain intensity), grade II (low disability, high pain intensity), grade III (high disability, moderately limiting), or grade IV (high disability, severely limiting) Visual analog scale (VAS): A widely used measure that evaluates pain intensity that has demonstrated reliability and validity for patients with OA . The VAS uses a 10‐cm line with “no pain” and “worst possible pain” located at each end, and participants are asked to indicate their average pain over the preceding 4 weeks by applying a vertical mark on the line …”

“…41,42 Visual analog scale (VAS): A widely used measure that evaluates pain intensity 43 that has demonstrated reliability and validity for patients with OA. 44 The VAS uses a 10-cm line with "no pain" and "worst possible pain" located at each end, and participants are asked to indicate their average pain over the preceding 4 weeks by applying a vertical mark on the line. 43 Measures of psychosocial symptoms:…”

Co-Occurring Symptoms Contribute to Persistent Fatigue in Prostate Cancer

“…Adding pain to the model further explained 21.7% of the variance ( F (2,19) = 15.88, p = 0.00009). Although depression scores (HAM-D) were well below the threshold of clinical depression (normal: 0–7; depression: ≥8) [29], adding depressive symptoms to the model resulted in a total of 73.9% of variance explained ( F (3,18) = 16.97, p = 0.00002). The differences in fatigue and its associated symptoms (LUTS, depressive symptoms, and pain) are shown in Figure 1.…”

“…The pain item provides a numeric rating of pain from 0 to 4 as well as descriptors that coincide with each number, i.e., “not at all,” “a little bit,” “somewhat,” “quite a bit,” and “very much” [19]. While not previously used as a single item to measure pain, item 4 does incorporate the concepts of a numeric rating scale and a verbal rating scale, which are commonly used in clinical practice [29] and have been validated and shown to correlate with one another with correlation coefficients ranging from 0.72 to 0.95 [29-31]. In addition, it has been previously shown in a review that single-item scales with 4–8 choices were found to be valid and reliable measures of pain, and ordinal data with 5 or more categories can be used for parametric analysis, thus supporting the stand-alone use of FACT-G item 4 which offers 5 numeric ratings [31, 32].…”

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“…Disability questionnaires included the Visual Analog Scale (VAS) (Jensen et al, 2003;Alghadir et al, 2018), Neck Disability Index (NDI) and Lower Extremity Function of Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ-LEF). The NDI is an instrument used to assess impairment of daily activity due to neck discomfort (Vernon and Mior, 1991).…”