Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr;12(1):8-12.
doi: 10.1055/s-0039-1683462. Epub 2019 Apr 17.

The Reliability of Remembered Pretreatment Visual Analog Scale Scores among Hand-Surgery Patients

Vilhjalmur Finsen  1   2 , Sigrun Hillesund  3 , Ida Fromreide  3
Affiliations

The Reliability of Remembered Pretreatment Visual Analog Scale Scores among Hand-Surgery Patients

Vilhjalmur Finsen et al. J Hand Microsurg. 2020 Apr.

Abstract

Background In clinical audits in which preoperative visual analog scale (VAS) scores were not recorded, it would be useful if such scores could be re-created at the time of review. Patients and Methods We recorded VAS score for pain during the past week before surgery for 245 consecutive hand-surgery patients scheduled for planned surgery during a 6-month period. A total of 30 patients who refused to participate or were unable to respond were excluded. The remaining 215 patients were contacted after 21 months and asked to furnish a new VAS score of the pain they remembered to have had during the last week before surgery. Responses were analyzed with a Bland-Altman plot. Results One hundred and thirty-one (61%) of the patients responded. The mean remembered preoperative score was higher than the mean real preoperative score in all diagnosis groups. The mean difference was 10 mm (standard deviation: 22 mm; standard error of the mean: 2 mm). The lower and upper limits of 95% agreement for individual scores were -33 and 53 mm, whereas the lower and upper limits of the 95% confidence interval of the mean were 6 and 14 mm. Conclusion It may be possible to predict the mean real preoperative VAS score in groups of patients with accuracy using the remembered preoperative score. In individual patients, remembered preoperative VAS scores are far too inaccurate to be of value. However, real preoperative scores should be used whenever possible.

Keywords: accuracy; pain; recall; remembered; visual analog score.

PubMed Disclaimer

Conflict of interest statement

Ethical ApprovalNoteAuthors’ ContributionsAvailability of Data and MaterialConflict of Interest This study was approved in writing by the regional committee for medical health research ethics for central Norway (ref. 2015/456). Patients were fully informed in writing about the purpose of our request for the remembered VAS and that the results would be published in a scientific paper. Those who responded to our letter and returned a remembered VAS were considered to have given their implied consent. V.F. conceived the study, analyzed the data, and wrote the paper. S.H. collected the data, analyzed the data, and wrote the paper. I.F. collected the data, analyzed the data, and wrote the paper. All data generated or analyzed during this study are included in the Supplementary Material (available in the online version). None declared.

Figures

Fig. 1
Fig. 1
Scatter plot of the remembered against the real preoperative visual analog scale (VAS) score and the line of perfect agreement.
Fig. 2
Fig. 2
Bland-Altman plot of the difference between the remembered and real preoperative VAS scores plotted against the average of the two scores. The solid line represents the mean difference. The dotted lines represent the lower and upper limits of agreement.
See this image and copyright information in PMC

References

    1. Hawker G A, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP) Arthritis Care Res (Hoboken) 2011;63 11:S240–S252. - PubMed
    1. Bijur P E, Silver W, Gallagher E J. Reliability of the visual analog scale for measurement of acute pai. Acad Emerg Med. 2001;8(12):1153–1157. - PubMed
    1. Bodian C A, Freedman G, Hossain S, Eisenkraft J B, Beilin Y. The visual analog scale for pain: clinical significance in postoperative patient. Anesthesiology. 2001;95(06):1356–1361. - PubMed
    1. Kjeldsen H B, Klausen T W, Rosenberg J. preferred presentation of the visual analog scale for measurement of postoperative pai. Pain Pract. 2016;16(08):980–984. - PubMed
    1. Myles P S, Myles D B, Galagher W et al. Measuring acute postoperative pain using the visual analog scale: the minimal clinically important difference and patient acceptable symptom stat. Br J Anaesth. 2017;118(03):424–429. - PubMed