Clinically significant changes in nausea as measured on a visual analog scale

Hendey, Gregory W.; Donner, N. F; Fuller, Kimberly

doi:10.1016/j.annemergmed.2004.07.446

Cited by 54 publications

(69 citation statements)

References 10 publications

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“…As previously mentioned, related studies using a 100-mm VAS suggest that a 20-mm change is associated with clinically significant change in symp- toms. [17][18][19][20] The difference in cervical dilation pain that we demonstrated (mean difference: Ϫ15.0 mm, relative difference between study groups: 20.0%, PϽ.05) may not accurately represent a true clinical difference. Further, concurrent assessment of intraoperative pain is difficult during surgical abortion.…”

Section: Discussioncontrasting

confidence: 54%

“…[17][18][19][20] We therefore defined effectiveness of treatment as a decrease (improvement) of 20 mm or greater on the 100-mm VAS compared with reported pain scores in the control group, or a relative difference of 20% between study groups. From prior experience, we estimated that the standard deviation (SD) of the VAS in abortion-related pain was 20 mm, assuming a normal distribution.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Paracervical Block With Combined Ketorolac and Lidocaine in First-Trimester Surgical Abortion

Cansino

Edelman

Burke

et al. 2009

Obstetrics &Amp; Gynecology

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Section: Discussioncontrasting

confidence: 54%

Section: Methodsmentioning

confidence: 99%

Paracervical Block With Combined Ketorolac and Lidocaine in First-Trimester Surgical Abortion

Cansino

Edelman

Burke

et al. 2009

Obstetrics &Amp; Gynecology

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“…This margin was selected because previous research has shown that the minimum clinically significant VAS change in nausea is 15 mm. 13 All measurements were made by investigators masked to the treatment allocation. We used an intention-to-treat analysis.…”

Section: Discussionmentioning

confidence: 99%

“…The VAS for nausea but not anxiety or sedation has been validated in adults. 13 The VAS was anchored at 0 (no nausea) and 100 (most nausea imaginable). Similar anchors were provided by anxiety and sedation or sleepiness.…”

Section: Measurementsmentioning

confidence: 99%

Ondansetron versus Promethazine to Treat Acute Undifferentiated Nausea in the Emergency Department: A Randomized, Double‐blind, Noninferiority Trial

Braude

Crandall

2008

Academic Emergency Medicine

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Objectives: The authors sought to compare ondansetron and promethazine among emergency department (ED) patients with undifferentiated nausea. The hypothesis was that ondansetron was not inferior to promethazine and that rates of adverse effects were similar.Methods: This was a randomized double-blind noninferiority clinical trial conducted in an urban academic ED. A convenience sample of nonpregnant adults with at least 40 mm of self-reported nausea measured on a 100-mm visual analog scale (VAS) were enrolled. Patients who had already received more than 1 L of intravenous fluid or an antiemetic agent were excluded. Subjects were block-randomized in groups of 10 to either 4 mg of ondansetron or 25 mg of promethazine delivered intravenously. The primary outcome was change in nausea over 30 minutes. The authors used a 15-mm margin of noninferiority. Secondary endpoints included changes in anxiety, sedation, and other adverse effects. Analyses included t-tests, tests for proportions, and 95% confidence intervals (CIs).Results: A total of 120 subjects completed the study, 60 in each arm. Baseline nausea, anxiety, and sedation scores were similar. Ondansetron and promethazine reduced nausea similarly (ondansetron )34 mm, promethazine )36 mm; difference )2 mm; 95% CI = )13 to 8 mm). The reduction in anxiety was similar (ondansetron )13 mm, promethazine )14 mm; difference )1 mm; 95% CI = )10 to 10 mm). Promethazine was associated with significantly more sedation than ondansetron (ondansetron 5 mm, promethazine 19 mm; difference 14 mm; 95% CI = 5 to 24 mm). There were no cases of akathisia in the ondansetron group and 2 cases in the promethazine group.Conclusions: Promethazine and ondansetron have similar efficacy in reducing nausea among ED patients. Change in anxiety was similar, but promethazine was associated with greater sedation.ACADEMIC EMERGENCY MEDICINE 2008; 15:209-215 ª

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“…14 In adults, the visual analog scale (VAS) is a validated self-assessment tool for measuring the severity of nausea (VAS-N) and pain (VAS-P). [15][16][17][18] The VAS-P has been used in children as young as 3 years, 19 with consistent reliability for those older than 7 years, 20 although pictorial scales of increasing pain intensity have superior reliability and validity in younger children. 20,21 The VAS has been used less frequently for estimating nausea severity in children, with more recent studies using the VAS-N in children as young as 4 years.…”

mentioning

confidence: 99%

Development and Validation of a Pictorial Nausea Rating Scale for Children

Baxter¹,

Watcha

Baxter³

et al. 2011

Pediatrics

128

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OBJECTIVE: The lack of a widely used, validated measure limits pediatric nausea management. The goal of this study was to create and validate a pictorial scale with regular incremental levels between scores depicting increasing nausea intensity. METHODS: A pictorial nausea scale of 0 to 10 with 6 faces (the Baxter Retching Faces [BARF] scale) was developed in 3 stages. The BARF scale was validated in emergency department patients with vomiting and in healthy patients undergoing day surgery procedures. Patients were presented with visual analog scales for nausea and pain, the pictorial Faces Pain Scale–Revised, and the BARF scale. Patients receiving opioid analgesics or antiemetic agents had their pain and nausea assessed before and 30 minutes after therapy. Spearman's ρ correlation coefficients were calculated. A Wilcoxon matched-pair rank test compared pain and nausea scores before and after antiemetic therapy. RESULTS: Thirty oncology patients and 15 nurses participated in the development of the scale, and 127 patients (52, emergency department; 75, day surgery) ages 7 to 18 years participated in the validation. The Spearman ρ correlation coefficient of the first paired BARF and visual analog scale for nausea scores was 0.93. Visual analog scales for nausea and BARF scores (P = .20) were significantly higher in patients requiring antiemetic agents and decreased significantly after treatment, while posttreatment pain scores (P = .47) for patients receiving only antiemetic agents did not. CONCLUSIONS: We describe the development of a pictorial scale with beginning evidence of construct validity for a self-report assessment of the severity of pediatric nausea. The scale had convergent and discriminant validity, along with an ability to detect change after treatment.

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Clinically significant changes in nausea as measured on a visual analog scale

Cited by 54 publications

References 10 publications

Paracervical Block With Combined Ketorolac and Lidocaine in First-Trimester Surgical Abortion

Paracervical Block With Combined Ketorolac and Lidocaine in First-Trimester Surgical Abortion

Ondansetron versus Promethazine to Treat Acute Undifferentiated Nausea in the Emergency Department: A Randomized, Double‐blind, Noninferiority Trial

Development and Validation of a Pictorial Nausea Rating Scale for Children

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