Validation of an Electronic Visual Analog Scale mHealth Tool for Acute Pain Assessment: Prospective Cross-Sectional Study.
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ABSTRACT:
SUBMITTER: Escalona-Marfil C
PROVIDER: S-EPMC7055746 | biostudies-literature | 2020 Feb
REPOSITORIES: biostudies-literature
Publications
Validation of an Electronic Visual Analog Scale mHealth Tool for Acute Pain Assessment: Prospective Cross-Sectional Study.
Escalona-Marfil Carles C Coda Andrea A Ruiz-Moreno Jorge J Riu-Gispert Lluís Miquel LM Gironès Xavier X
Journal of medical Internet research 20200212 2
<h4>Background</h4>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.<h4>Objective</h4>This study aimed to validate a new method of re ...[more]
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Project description:BackgroundTo quantify pain severity in patients and the efficacy treatments, researchers and clinicians apply tools such as the traditional visual analog scale (VAS) that leads to inaccurate interpretation of the main sensory pain.ObjectiveThis study aimed to validate the pain measurements of a neuroscience-based 3D body pain mobile app called GeoPain.MethodsPatients with temporomandibular disorder (TMD) were assessed using GeoPain measures in comparison to VAS and positive and negative affect schedule (PANAS), pain and mood scales, respectively. Principal component analysis (PCA), scatter score analysis, Pearson methods, and effect size were used to determine the correlation between GeoPain and VAS measures.ResultsThe PCA resulted in two main orthogonal components: first principal component (PC1) and second principal component (PC2). PC1 comprises a combination score of all GeoPain measures, which had a high internal consistency and clustered together in TMD pain. PC2 included VAS and PANAS. All loading coefficients for GeoPain measures in PC1 were above 0.70, with low loadings for VAS and PANAS. Meanwhile, PC2 was dominated by a VAS and PANAS coefficient >0.4. Repeated measure analysis revealed a strong correlation between the VAS and mood scores from PANAS over time, which might be related to the subjectivity of the VAS measure, whereas sensory-discriminative GeoPain measures, not VAS, demonstrated an association between chronicity and TMD pain in locations spread away from the most commonly reported area or pain epicenter (P=.01). Analysis using VAS did not detect an association at baseline between TMD and chronic pain. The long-term reliability (lag >1 day) was consistently high for the pain area and intensity number summation (PAINS) with lag autocorrelations averaging between 0.7 and 0.8, and greater than the autocorrelations for VAS averaging between 0.3 and 0.6. The combination of higher reliability for PAINS and its objectivity, displayed by the lack of association with PANAS as compared with VAS, indicated that PAINS has better sensitivity and reliability for measuring treatment effect over time for sensory-discriminative pain. The effect sizes for PAINS were larger than those for VAS, consequently requiring smaller sample sizes to assess the analgesic efficacy of treatment if PAINS was used versus VAS. The PAINS effect size was 0.51 SD for both facial sides and 0.60 SD for the right side versus 0.35 SD for VAS. Therefore, the sample size required to detect such effect sizes with 80% power would be n=125 per group for VAS, but as low as n=44 per group for PAINS, which is almost a third of the sample size needed by VAS.ConclusionsGeoPain demonstrates precision and reliability as a 3D mobile interface for measuring and analyzing sensory-discriminative aspects of subregional pain in terms of its severity and response to treatment, without being influenced by mood variations from patients.
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Project description:BackgroundNew technology for clinical data collection is rapidly evolving and may be useful for both researchers and clinicians; however, this new technology has not been tested for accuracy, reliability, or validity.ObjectiveThis study aims to test the accuracy of visual analog scale (VAS) for pain on a newly designed application on the iPad (iPadVAS) and measure the reliability and validity of iPadVAS compared to a paper copy (paperVAS).MethodsAccuracy was determined by physically measuring an iPad scale on screen and comparing it to the results from the program, with a researcher collecting 101 data points. A total of 22 healthy community dwelling older adults were then recruited to test reliability and validity. Each participant completed 8 VAS (4 using each tool) in a randomized order. Reliability was measured using interclass correlation coefficient (ICC) and validity measured using Bland-Altman graphs and correlations.ResultsOf the measurements for accuracy, 64 results were identical, 2 results were manually measured as being 1 mm higher than the program, and 35 as 1 mm lower. Reliability for the iPadVAS was excellent with individual ICC 0.90 (95% CI 0.82-0.95) and averaged ICC 0.97 (95% CI 0.95-1.0) observed. Linear regression demonstrated a strong relationship with a small negative bias towards the iPad (-2.6, SD 5.0) with limits of agreement from -12.4 to 7.1.ConclusionsThe iPadVAS provides a convenient, user-friendly, and efficient way of collecting data from participants in measuring their current pain levels. It has potential use in documentation management and may encourage participatory healthcare.Trial registrationAustralia New Zealand Clinical Trials Registry (ANZCTR): 367297; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367297&isReview=true (Archived by Webcite at http://www.webcitation.org/6d9xYoUbD).
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Project description:IntroductionPatients with chronic cough experience considerable burden. The cough severity visual analog scale (VAS) records patients' assessment of cough severity on a 100-mm linear scale ranging from "no cough" (0 mm) to "worst cough" (100 mm). Although cough severity scales are widely used in clinical practice and research, their use in patients with refractory or unexplained chronic cough has not been formally validated.MethodsThis analysis includes data from a phase 2b randomized controlled trial of the P2X3-receptor antagonist gefapixant for treatment of refractory or unexplained chronic cough (NCT02612610). Cough severity VAS scores were assessed at baseline and Weeks 4, 8, and 12. The cough severity VAS was validated using several outcomes, including the Cough Severity Diary (CSD), Leicester Cough Questionnaire (LCQ), patient global impression of change (PGIC) scale, and objective cough frequency. Validation metrics included test-retest reliability, convergent and known-groups validity, responsiveness, and score interpretation (i.e., clinically meaningful change threshold).ResultsThe analysis included 253 patients (median age, 61.0 years; females, 76%). Test-retest reliability of the cough severity VAS was moderate (intraclass correlation coefficient, 0.51). The cough severity VAS had acceptable convergent validity with other related measures (Pearson r of 0.53 and -0.41 for CSD and LCQ total scores, respectively; p < 0.0001 for each). Known-groups validity was supported by significant differences in mean cough severity VAS scores across severity groups defined using CSD, LCQ, and cough frequency tertiles. A large effect size was observed in patients with the greatest improvements in PGIC (Cohen d = -1.8). A ⩾ 30-mm reduction in the cough severity VAS was estimated as a clinically meaningful change threshold for clinical trials in chronic cough.ConclusionsThe cough severity VAS is a valid and responsive measure. A cough severity VAS reduction of ⩾ 30 mm can discriminate clinically meaningful changes in chronic cough severity in clinical studies.
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Project description:BackgroundGreater trochanteric pain syndrome (GTPS) possesses a harmful influence on quality of life. Numerous conservative management modalities with varying success have been proposed for patients with GTPS. However, it is not clear which treatment is more effective for reducing pain. The purpose of this Bayesian analysis was to assess the current evidence for the effectiveness of conservative treatments on improving Visual Analog Scale (VAS) pain scoring of GTPS and to determine the most effective treatment protocol.MethodsA comprehensive study search was performed from inception until July 18, 2022, via the electronic databases PubMed, the Cochrane Library, and Web of Science for potential research. The risk of bias assessment for the included studies was independently performed based on the Cochrane Collaboration Risk of Bias Tool. Bayesian analysis was conducted by using ADDIS software (v1.16.5). The DerSimonian-Laird random effects model was used to perform the traditional pairwise meta-analysis.ResultsEight full-text articles with a total of 596 patients with GTPS were included in the analysis. In comparing ultrasound-guided platelet-rich plasma application (PRP-U) to ultrasound-guided corticosteroid injection (CSI-U), patients who received PRP therapy experienced reduced pain as the VAS decreased significantly (MD, -5.21; 95% CI, -6.24 to -3.64). VAS score in group of extracorporeal shockwave treatment (ESWT) was significant improved than that in exercise (EX) group (MD, -3.17; 95% CI, -4.13 to -2.15). There were no statistically significantly different VAS scores between the CSI-U group and the CSI under landmark (CSI-B) group. The treatment efficacy rankings of the different treatments on improving VAS scores showed that the most likely efficacious treatment was PRP-U (99%) followed by ESWT (81%), CIS-U (58%), usual care (48%), CIS-B (54%), and EX (84%).ConclusionBayesian analysis revealed that PRP injection and ESWT are relatively safe and effective in the treatment of GTPS. More multicenter high-quality randomized clinical trials with large sample sizes are still needed in the future to provide further evidence.
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Project description:PurposeTo survey the clinical satisfaction of patients who have had an endoscopic piriformis release with a sciatic nerve neurolysis.MethodsPatients with piriformis syndrome (PS) who were treated with an endoscopic piriformis release combined with a sciatic neurolysis between 2013 and 2018 were identified. All patients had a minimum follow-up of 1 year. Patients were contacted by telephone in 201,9 whereby the rate of satisfaction and pain were evaluated with the Benson surgery scale and the visual analog scale (VAS).ResultsThe average duration of symptoms at first presentation was 34 months (range 16-54 months). Thirty-seven cases (82,2%) had an EMG that showed sciatic compression around the piriformis muscle. The average preoperative VAS pain score was 7.4 (± 0.8). The mean VAS score at the time of the survey was 1.9 (± 2.4). The difference in median preoperative and postoperative VAS was 6. Using the Wilcoxon signed-rank test, we found there was a significant improvement of VAS score (with P < .001). Using the Benson operative scale, we found that outcomes at the time of the survey were excellent in 23 patients (24 cases, 53.4%), good in 10 (22.2%), fair in 3 (6.7%), and poor in 8 (17.7%). Three patients with a poor result had a wrong diagnosis of PS and ended up needing treatment for a different diagnosis. In total, 33 patients answered affirmative on the question if they would undergo the procedure again. Apart from 3 local wound infections, no major complications were observed.ConclusionsOnce a diagnosis is made, the endoscopic release of the piriformis tendon results in significant improvement in Pain VAS scores for patients with refractory symptoms despite conservative treatment.Level of evidenceLevel IV, therapeutic case series.
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Project description:Interpersonal theory organizes social behavior along dominant (vs. submissive) and warm (vs. cold) dimensions. There is a growing interest in assessing these behaviors in naturalistic settings to maximize ecological validity and to study dynamic social processes. Studies that have assessed interpersonal behavior in daily life have primarily relied on behavioral checklists. Although checklists have advantages, they are discrepant with techniques used to capture constructs typically assessed alongside warmth and dominance, such as affect, which typically rely on adjective descriptors. Further, these checklists are distinct from the methodologies used at the dispositional level, such as personality inventories, which rarely rely on behavioral checklists. The present study evaluates the psychometric performance of interpersonal adjectives presented on a visual analog scale in five different samples. Validity of the Visual Interpersonal Analog scale (VIAS) approach to momentary assessment was evaluated by comparing its performance with an interpersonal behavior checklist and by examining associations among the VIAS Warmth and Dominance scales and other momentary and dispositional constructs. Results were generally consistent with an existing interpersonal behavior checklist at the within-person level but diverged somewhat at the dispositional level. Across the five samples, the VIAS generally performed as hypothesized at both the within- and between-person levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Project description:Background: Deep brain stimulation (DBS) has become a standard treatment for advanced stages of Parkinson's disease, essential tremor, and dystonia. In addition to the correct surgical device implantation, effective programming is regarded to be the most important factor for clinical outcome. Despite established strategies for adjusting neurostimulation, DBS programming remains time- and resource-consuming. Although kinematic and neuronal biosignals have recently been examined as potential feedback for closed-loop DBS (CL-DBS), there is an ongoing need for programming strategies to adapt the stimulation parameters and electrode configurations accurately and effectively. Methods: Here, we tested the usefulness of a patient-rated visual analog scale (VAS) for real-time adjustment of DBS parameters. The stimulation parameters (contact and amplitude) in Parkinson's patients with STN-DBS (n = 17) were optimized based on the patient's subjective VAS rating. A Minkowski distance (Md) was calculated to compare the individual combination of contact selection and amplitude to the stimulation parameters that resulted from classical programming based on clinical signs and symptoms. Results: We found no statistically significant difference between VAS-based and classical programming in regard to the specific contact or amplitude used or in regard to the clinical disease severity (UPDRS). Conclusions: Our data suggest that VAS-based and classical programming strategies both lead to similar short-term results. Although further research will be required to assess the validity of VAS-based DBS programming, our results support the investigation of the patient's subjective rating as an additional and valid feedback signal for individualized DBS adjustment.
| S-EPMC7661931 | biostudies-literature
Project description:BackgroundMobile devices have greatly facilitated the use of digital health resources, particularly during the COVID-19 pandemic. Mobile health (mHealth) has become a common and important way to monitor and improve health conditions for people from different social classes. The ability to utilize mHealth affects its effectiveness; therefore, the widespread application of mHealth technologies calls for an instrument that can accurately measure health literacy in the era of mobile media.ObjectiveWe aimed to (1) identify the components of mHealth literacy for ordinary users and (2) develop a systematic scale for appropriately measuring individuals' self-perceived mHealth literacy through a problem-based framework.MethodsWe conducted an exploratory study involving in-depth interviews and observations (15 participants) in January 2020 and used exploratory factor analysis and confirmatory factor analysis to identify the components of mHealth literacy and develop an item pool. In February 2020, we conducted a pilot survey with 148 participants to explore the factor structures of items identified during the exploratory study. Subsequently, 2 surveys were administrated using quota sampling. The first survey (conducted in Guangdong, China) collected 552 responses during March 2020; we assessed composite reliability, convergent validity, and discriminant validity. The second survey (conducted in China nationwide) collected 433 responses during October 2021; we assessed criterion-related validity using structural equation modeling.ResultsWe identified 78 items during the exploratory study. The final scale-the Problem-Based mHealth Literacy Scale-consists of 33 items that reflect 8 domains of mHealth literacy. The first web-based survey suggested that mHealth literacy consists of 8 factors (ie, subscales), namely, mHealth desire, mobile phone operational skills, acquiring mHealth information, acquiring mHealth services, understanding of medical terms, mobile-based patient-doctor communication, evaluating mHealth information, and mHealth decision-making. These factors were found to be reliable (composite reliability >0.7), with good convergent validity (average variance extracted >0.5) and discriminant validity (square root of average variance extracted are greater than the correlation coefficients between factors). The findings also revealed that these 8 factors should be grouped under a second-order factor model (χ2/df=2.701; comparative fit index 0.921; root mean square error of approximation 0.056; target coefficient 0.831). The second survey revealed that mHealth use had a significant impact (β=0.43, P<.001) on mHealth literacy and that mHealth literacy had a significant impact (β=0.23, P<.001) on health prevention behavior.ConclusionsThis study revealed the distinctiveness of mHealth literacy by placing mHealth needs, the ability to understand medical terms, and the skills in patient-doctor interactions in the foreground. The Problem-Based mHealth Literacy Scale is a useful instrument for comprehensively measuring individuals' mHealth literacy and extends the concept of health literacy to the context of mobile communication.
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Project description:BackgroundLivedoid vasculopathy is an orphan skin disease characterized by recurrent thrombosis of the cutaneous microcirculation. It manifests itself almost exclusively in the ankles, the back of the feet, and the distal part of the lower legs. Because of the vascular occlusion, patients suffer from intense local ischemic pain. Incidence of livedoid vasculopathy is estimated to be around 1:100,000. There are currently no approved treatments for livedoid vasculopathy, making off-label therapy the only option. In Europe, thromboprophylactic treatment with low-molecular-weight heparins has become widely accepted.ObjectiveThe aim of this trial is the statistical verification of the therapeutic effects of the anticoagulant rivaroxaban in patients suffering from livedoid vasculopathy.MethodsWe performed a therapeutic phase IIa trial designed as a prospective, one-armed, multicenter, interventional series of cases with a calculated sample size of 20 patients. The primary outcome is the assessment of local pain on the visual analog scale (VAS) as an intraindividual difference of 2 values between baseline and 12 weeks.ResultsEnrollment started in December 2012 and was still open at the date of submission. The study is expected to finish in November 2014.ConclusionsLivedoid vasculopathy is associated with increased thrombophilia in the cutaneous microcirculation and the continuous use of anticoagulants helps improve the symptoms. The causes of cutaneous infarctions are heterogenous, but ultimately follow the known mechanisms of the coagulation cascade. Rivaroxaban affects the coagulation cascade and inhibits the factor Xa-dependent conversion of prothrombin to thrombin, thereby considerably reducing the risk of thrombosis.Trial registrationTrial Registration EudraCT Number: 2012-000108-13-DE; https://www.clinicaltrialsregister.eu/ctr-search/search?query=eudract_number:2012-000108-13 (Archived by WebCite at http://www.webcitation.org/6UCktWVCA); German Clinical Trials Register (DRKS): DRKS00004652; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00004652 (Archived by WebCite at http://www.webcitation.org/6UCIAKyCS).
| S-EPMC4275467 | biostudies-literature
Project description:Purpose: To evaluate medium-term clinical outcomes of transcatheter embolization and stenting in women with several pelvic venous disorders responsible for chronic pelvic pain and varicose veins of the lower limbs. Materials and Methods: The study population included 327 consecutively recruited patients referred to the interventional radiology unit from January 2014 to December 2019 due to chronic pelvic congestion (91; 27.83%), lower limb varices (15; 4.59%), or a combination of both the symptoms (221; 67.58%). Preprocedural pelvic, transvaginal Doppler ultrasound (US), and MRI were conducted in all the patients and revealed anatomical varicosities and incompetent pelvic veins in 312 patients. In all the patients, selective catheterization demonstrated uterine venous engorgement, ovarian plexus congestion, or pelvic vein filling. Retrograde flow was detected on catheter venography in the left ovarian vein (250; 78%), the right ovarian vein (85; 26%), the left internal iliac vein (222; 68%), and the right internal iliac vein (185; 57%). Patients were followed-up at 1, 6, and 12 months, and years thereafter systematically by the referring angiologist and the interventional radiologist of center. They were contacted by telephone in November and December 2020 to assess pain perception and quality of life by using the visual analog scales from 0 to 10 with assessments made at the baseline and last follow-up. Of the 327 patients (mean age, 42 ± 12 years), 312 patients were suffering from pelvic congestion syndrome and 236 patients was suffering from lower limb varices. All underwent embolization by using ethylene vinyl alcohol copolymer (Onyx®). Eighty-five right ovarian veins, 249 left ovarian veins, 510 tributaries of the right internal iliac vein, and 624 tributaries of the left internal iliac vein were embolized. A cohort of patients also underwent nutcracker syndrome angioplasty (6.7%) and May-Thurner syndrome angioplasty (14%) with a stent placement. Results: The initial technical success rate was 80.9% for embolization of pathological veins and 100% for stenting of stenoses. Overall, 307 patients attended 12-month follow-up visits and 288 (82%) patients completed the telephone survey at mean 39 (±18)-month postintervention. Main pelvic pain significantly improved from 6.9 (±2.4) pre- to 2.0 (±2.4) postembolization (p < 0.001), as did specific symptoms in each category. Improvement or disappearance of pain was achieved in 266/288 (92.36%) patients with improved quality of life in 276/288 (95.8%) patients. There were 16 minor and 4 major adverse events reported on the follow-up. Conclusion: Pelvic vein embolization (Onyx®) is an effective and safe procedure with high clinical success and quality of life improvement rates.
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