Studies Comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for Assessment of Pain Intensity in Adults: A Systematic Literature Review

Abstract

NRSs are applicable for unidimensional assessment of PI in most settings. Whether the variability in anchors and response options directly influences the numerical scores needs to be empirically tested. This will aid in the work toward a consensus-based, standardized measure.

Defining an International Standard Set of Outcome Measures for Patients With Hip or Knee Osteoarthritis: Consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group

“…It is common to assess pain using visual analog scales (VAS) or numeric rating scales (NRS). Despite their differences in granularity, possible modes of collection, and presentation requirements, these instruments provide congruent results 23. Therefore, to facilitate implementation and align with current practices, the working group agreed to recommend assessment of joint pain via either VAS or NRS (11‐item version) using a 1‐week recall period 19, 20.…”

Comparison of the inter- and intra-observer repeatability of three gait-scoring scales for sows

“…Viñuela-Fernández et al (2011) observed a higher repeatability when students scored horse laminitis on a VAS compared with two ordinal scales. Finally, in their comprehensive review of the literature comparing the available clinical tools for the self-reporting of pain in human patients, Hjermstad et al (2011) found that the most commonly used scales (i.e. a numerical rating scale with 11 categories, a verbal rating scale with 7 categories, and a 100-mm VAS) had comparable performances.…”

“…However, the aggregation of categories or their retrospective simplification has been recommended by some authors as one of the methods to increase inter-observer repeatability when assessing lameness in practical settings (Brenninkmeyer et al, 2007;Channon et al, 2009;D'Eath, 2012) and the use of few gait-scoring categories is indeed common in farm assurance schemes for pigs (Welfare Quality ® , 2009;RSPCA, 2012;BPEX, 2013). The number of scores available in any given scale is important because it determines the smallest degree of discrimination possible: scales with only two or three response levels offer limited opportunity to fully exploit the trained observer's discriminative capacities (Hjermstad et al, 2011). From an epidemiological and animal welfare perspective, the reduction of the number of gaitscoring categories, particularly when these are reduced to a simple 'lame/non-lame' classification, is likely to entail the loss of potentially important information on the lameness status of individual sows and of entire sow herds.…”

“…At the opposite end of the spectrum relative to the simplification of scoring systems are visual analogue scales (VASs). These can be used in both humans and animals to assess physiological phenomena (including pain and lameness) that are considered to range across a continuum of values (Tuyttens et al, 2009;Hjermstad et al, 2011;Viñuela-Fernández et al, 2011). The much larger range of available scores means that it is possible to record a change on a VAS when a change in category would not be achieved (Averbuch and Katzper, 2004).…”

Utility of the visual analog scale for the assessment of dental anxiety

“…Unfortunately, only individual reports can be found in the available literature in which the VAS (taken from the pain assessment methodology) has been used to assess anxiety in hospitalized patients awaiting surgery. 8 In the Polish literature, however, there is no study on the use of VAS to evaluate dental anxiety.…”