Boonstra Anne M, Schiphorst Preuper Henrica R, Balk Gerlof A, Stewart Roy E
Revalidatie Friesland Centre for Rehabilitation, Beetsterzwaag, The Netherlands Department of Rehabilitation, Center for Rehabilitation, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands Department of Health Sciences, Community and Occupational Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Pain. 2014 Dec;155(12):2545-2550. doi: 10.1016/j.pain.2014.09.014. Epub 2014 Sep 17.
The aim of this study was to find the cut-off points on the visual analogue scale (VAS) to distinguish among mild, moderate, and severe pain, in relation to the following: pain-related interference with functioning; verbal description of the VAS scores; and latent class analysis for patients with chronic musculoskeletal pain. A total of 456 patients were included. Pain was assessed using the VAS and verbal rating scale; functioning was assessed using the domains of the Short Form (36) Health Survey (SF-36). Eight cut-off point schemes were tested using multivariate analysis of variance (MANOVA), ordinal logistic regression, and latent class analysis. The study results showed that VAS scores ⩽ 3.4 corresponded to mild interference with functioning, whereas 3.5 to 6.4 implied moderate interference, and ⩾ 6.5 implied severe interference. VAS scores ⩽ 3.4 were best described for patients with chronic musculoskeletal pain as mild pain, 3.5 to 7.4 as moderate pain, and ⩾ 7.5 as severe pain. Latent class analysis found that a 3-class solution fitted best, resulting in the classes 0.1 to 3.8, 3.9 to 5.7, and 5.8 to 10 cm. Findings from our study agree with those of some other studies, although many other studies found different optimal cut-off point schemes. As there appear to be no universally accepted cut-off points, and in view of the low-to-moderate associations between VAS scores and functioning and between VAS and verbal rating scale scores, the correct classification of VAS scores as mild, moderate. or severe in clinical practice seems doubtful.
本研究的目的是找出视觉模拟评分量表（VAS）上区分轻度、中度和重度疼痛的临界点，具体涉及以下方面：与功能相关的疼痛干扰；VAS评分的文字描述；以及慢性肌肉骨骼疼痛患者的潜在类别分析。共纳入456例患者。使用VAS和文字评定量表评估疼痛；使用简短健康调查问卷（SF-36）的各个领域评估功能。使用多变量方差分析（MANOVA）、有序逻辑回归和潜在类别分析测试了八种临界点方案。研究结果表明，VAS评分≤3.4对应对功能的轻度干扰，3.5至6.4意味着中度干扰，≥6.5意味着重度干扰。对于慢性肌肉骨骼疼痛患者，VAS评分≤3.4最适合描述为轻度疼痛，3.5至7.4为中度疼痛，≥7.5为重度疼痛。潜在类别分析发现，三类解决方案拟合最佳，结果为0.1至3.8、3.9至5.7和5.8至10厘米这几个类别。我们研究的结果与其他一些研究的结果一致，尽管许多其他研究发现了不同的最佳临界点方案。由于似乎没有普遍接受的临界点，并且鉴于VAS评分与功能之间以及VAS与文字评定量表评分之间的关联为低至中度，在临床实践中将VAS评分正确分类为轻度、中度或重度似乎存在疑问。
