Objectives

Visual analogue scale (VAS) and numeric rating scale (NRS) are two commonly used instruments for measuring pain intensity. Both instruments are validated for use in both clinical and research settings, and share a range of similar aspects. Some studies have shown that the two instruments may be used interchangeably, but the results are conflicting. In this study we assessed whether the VAS and the NRS instruments may be used interchangeably when measuring pain intensity in older adults.

Methods

Data were collected in a cross-sectional study, as part of the follow-up in a larger longitudinal study conducted at the Akershus University Hospital, Norway 2021 to 2022 and included 39 older adults aged ≥65. Participants were regarded as a normal older adult population as they were not recruited on basis of a specific condition or reports of pain. The participants were asked to rate their pain intensity on an average day using VAS and NRS. Bland-Altman analysis was performed to assess agreement between the two instruments.

Results

Thirty-seven participants with mean (SD) age of 77 (5.9) were included in the analysis. Mean (SD) pain assessed by VAS and NRS was 2.8 (1.8) and NRS 4.7 (2.2), respectively. A mean difference (SD) of 2.0 (1.9) between the scores of the two instruments was statistically significantly different from zero (p < 0.001) confirming bias. The 95% limits of agreement were estimated to be −1.7 to 5.7. A post-hoc analysis, removing an outlier, resulted in similar conclusions.

Conclusion

There was poor agreement between the VAS and NRS scale for measuring pain intensity in older adults. This suggests that the two instruments should not be used interchangeably when assessing pain intensity in this population.

Ethical approval

Regional Committees for Medical and Health Research Ethics [2016/2289].

Trial registration.

NCT03162081, 22 May 2017.

中文翻译：

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测量老年人的疼痛强度。视觉模拟量表和数字评分量表可以互换使用吗？

目标

视觉模拟量表（VAS）和数字评定量表（NRS）是测量疼痛强度的两种常用工具。这两种仪器都经过验证，可用于临床和研究环境，并且具有一系列相似的方面。一些研究表明，这两种仪器可以互换使用，但结果是相互矛盾的。在这项研究中，我们评估了在测量老年人的疼痛强度时，VAS 和 NRS 仪器是否可以互换使用。

方法

数据是在一项横断面研究中收集的，作为挪威阿克斯胡斯大学医院 2021 年至 2022 年进行的一项更大规模纵向研究的一部分，该研究纳入了 39 名年龄≥65 岁的老年人。参与者被视为正常的老年人群，因为他们不是根据特定状况或疼痛报告而招募的。参与者被要求使用 VAS 和 NRS 评估平均每天的疼痛强度。进行 Bland-Altman 分析以评估两种仪器之间的一致性。

结果

分析中包括 37 名平均 (SD) 年龄为 77 (5.9) 岁的参与者。VAS 和 NRS 评估的平均 (SD) 疼痛分别为 2.8 (1.8) 和 NRS 4.7 (2.2)。两种仪器得分之间的平均差 (SD) 为 2.0 (1.9)，在统计上显着不同于零 ( p  < 0.001)，证实了偏倚。95% 的一致限度估计为 -1.7 至 5.7。消除异常值的事后分析得出了类似的结论。

结论

用于测量老年人疼痛强度的 VAS 和 NRS 量表之间的一致性较差。这表明在评估该人群的疼痛强度时，这两种仪器不应互换使用。

道德认可

医疗和健康研究伦理区域委员会[2016/2289]。

试用注册。

NCT03162081，2017年 5 月 22 日。