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. 2020 Feb 12;22(2):e13468.
doi: 10.2196/13468.

Validation of an Electronic Visual Analog Scale mHealth Tool for Acute Pain Assessment: Prospective Cross-Sectional Study

Carles Escalona-Marfil  1   2 , Andrea Coda  3 , Jorge Ruiz-Moreno  4 , Lluís Miquel Riu-Gispert  1 , Xavier Gironès  1
Affiliations

Validation of an Electronic Visual Analog Scale mHealth Tool for Acute Pain Assessment: Prospective Cross-Sectional Study

Carles Escalona-Marfil et al. J Med Internet Res. .

Abstract

Background: Accurate measurement of pain is required to improve its management and in research. The visual analog scale (VAS) on paper format has been shown to be an accurate, valid, reliable, and reproducible way to measure pain intensity. However, some limitations should be considered, some of which can be implemented with the introduction of an electronic VAS version, suitable to be used both in a tablet and a smartphone.

Objective: This study aimed to validate a new method of recording pain level by comparing the traditional paper VAS with the pain level module on the newly designed Interactive Clinics app.

Methods: A prospective observational cross-sectional study was designed. The sample consisted of 102 participants aged 18 to 65 years. A Force Dial FDK 20 algometer (Wagner Instruments) was employed to induce mild pressure symptoms on the participants' thumbs. Pain was measured using a paper VAS (10 cm line) and the app.

Results: Intermethod reliability estimated by ICC(3,1) was 0.86 with a 95% confidence interval of 0.81 to 0.90, indicating good reliability. Intramethod reliability estimated by ICCa(3,1) was 0.86 with a 95% confidence interval of 0.81 to 0.90, also indicating good reliability. Bland-Altman analysis showed a difference of 0.175 (0.49), and limits of agreement ranged from -0.79 to 1.14.

Conclusions: The pain level module on the app is highly reliable and interchangeable with the paper VAS version. This tool could potentially help clinicians and researchers precisely assess pain in a simple, economic way with the use of a ubiquitous technology.

Keywords: mHealth; mobile phone; pain; pain measurement; tablet; validation; visual analog pain scale.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Screenshot of the pain level module on the Interactive Clinics app.
Figure 2
Figure 2
Force Dial FDK 20 algometer (Wagner Instruments) used to cause acute pain.
Figure 3
Figure 3
Pressure application procedure with the algometer.
Figure 4
Figure 4
Scatter plot of the data (points are represented by subject number).
Figure 5
Figure 5
Rating data for the two methods.
Figure 6
Figure 6
Normal distribution of the differences.
Figure 7
Figure 7
Bland-Altman plot of differences between methods against the average of the two. Red line is the zero reference value for difference. Black lines represent the sample mean, limits of agreement, and 95% confidence intervals.
See this image and copyright information in PMC

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