Hielm-Björkman Anna K, Kapatkin Amy S, Rita Hannu J
Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, 00014 Helsinki, Finland.
Am J Vet Res. 2011 May;72(5):601-7. doi: 10.2460/ajvr.72.5.601.
OBJECTIVE: To assess validity and reliability for a visual analogue scale (VAS) used by owners to measure chronic pain in their osteoarthritic dogs. SAMPLE: 68, 61, and 34 owners who completed a questionnaire. PROCEDURES: Owners answered questionnaires at 5 time points. Criterion validity of the VAS was evaluated for all dogs in the intended-to-treat population by correlating scores for the VAS with scores for the validated Helsinki Chronic Pain Index (HCPI) and a relative quality-of-life scale. Intraclass correlation was used to assess repeatability of the pain VAS at 2 baseline evaluations. To determine sensitivity to change and face validity of the VAS, 2 blinded, randomized control groups (17 dogs receiving carprofen and 17 receiving a placebo) were analyzed over time. RESULTS: Significant correlations existed between the VAS score and the quality-of-life scale and HCPI scores. Intraclass coefficient (r = 0.72; 95% confidence interval, 0.57 to 0.82) for the VAS indicated good repeatability. In the carprofen and placebo groups, there was poor correlation between the 2 pain evaluation methods (VAS and HCPI items) at the baseline evaluation, but the correlation improved in the carprofen group over time. No correlation was detected for the placebo group over time. CONCLUSIONS AND CLINICAL RELEVANCE: Although valid and reliable, the pain VAS was a poor tool for untrained owners because of poor face validity (ie, owners could not recognize their dogs' behavior as signs of pain). Only after owners had seen pain diminish and then return (after starting and discontinuing NSAID use) did the VAS have face validity.
目的:评估宠物主人用于测量患骨关节炎犬慢性疼痛的视觉模拟评分法(VAS)的有效性和可靠性。 样本:68名、61名和34名完成问卷的宠物主人。 程序:宠物主人在5个时间点回答问卷。通过将VAS评分与经过验证的赫尔辛基慢性疼痛指数(HCPI)评分和相对生活质量量表评分进行关联,评估意向性治疗人群中所有犬的VAS标准效度。组内相关系数用于评估疼痛VAS在2次基线评估时的可重复性。为了确定VAS对变化的敏感性和表面效度,对2个盲法随机对照组(17只接受卡洛芬治疗的犬和17只接受安慰剂治疗的犬)进行了长期分析。 结果:VAS评分与生活质量量表评分和HCPI评分之间存在显著相关性。VAS的组内系数(r = 0.72;95%置信区间,0.57至0.82)表明具有良好的可重复性。在卡洛芬组和安慰剂组中,基线评估时两种疼痛评估方法(VAS和HCPI项目)之间的相关性较差,但卡洛芬组的相关性随时间有所改善。安慰剂组随时间未检测到相关性。 结论及临床意义:尽管疼痛VAS有效且可靠,但由于表面效度差(即主人无法将其犬的行为识别为疼痛迹象),对于未经培训的主人来说是一个较差的工具。只有在主人看到疼痛减轻然后又复发(开始和停止使用非甾体抗炎药后),VAS才具有表面效度。
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