Myrvik Matthew P, Drendel Amy L, Brandow Amanda M, Yan Ke, Hoffmann Raymond G, Panepinto Julie A
*Medical College of Wisconsin †Division of Pediatric Hematology/Oncology/Transplant ‡Division of Pediatric Emergency Medicine §Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI.
J Pediatr Hematol Oncol. 2015 Apr;37(3):190-4. doi: 10.1097/MPH.0000000000000306.
Given the availability of various pain severity scales, greater understanding of the agreement between pain scales is warranted. We compared Visual Analog Scale (VAS) and Numeric Rating Scale (NRS) pain severity ratings in children with sickle cell disease (SCD) to identify the relationship and agreement between pain scale ratings. Twenty-eight patients (mean ± SD age, 14.65 ± 3.12 y, 50% female) receiving pain interventions within the emergency department completed serial VAS and NRS pain severity ratings every 30 minutes. Data were used to calculate the relationship (Spearman correlation) and agreement (Bland-Altman approach) between the VAS and NRS. One hundred twenty-eight paired VAS-NRS measurements were obtained. VAS and NRS ratings were significantly correlated for the initial assessment (rs = 0.88, P < 0.001) and all assessments (rs = 0.87, P < 0.001). Differences between VAS and NRS means were -0.52 (P = 0.006) for the initial assessment and -0.86 (P < 0.001) across all assessments. The difference between VAS and NRS ratings decreased as pain severity increased across all assessments (P = 0.027), but not the initial assessment. Within pediatric patients with SCD, VAS and NRS ratings were found to trend together; however, VAS scores were found to be significantly lower than NRS scores across assessments. The agreement between the 2 measures improved at increasing levels of pain severity. These findings demonstrate that the VAS and NRS are similar, but cannot be used interchangeably when assessing self-reported pain in SCD.
鉴于有多种疼痛严重程度量表可供使用，有必要更深入地了解这些疼痛量表之间的一致性。我们比较了镰状细胞病（SCD）患儿的视觉模拟量表（VAS）和数字评定量表（NRS）的疼痛严重程度评分，以确定疼痛量表评分之间的关系和一致性。28例在急诊科接受疼痛干预的患者（平均年龄±标准差，14.65±3.12岁，50%为女性）每30分钟完成一次连续的VAS和NRS疼痛严重程度评分。数据用于计算VAS和NRS之间的关系（Spearman相关性）和一致性（Bland-Altman方法）。共获得128对VAS-NRS测量值。VAS和NRS评分在初始评估时显著相关（rs = 0.88，P < 0.001），在所有评估中也显著相关（rs = 0.87，P < 0.001）。初始评估时VAS和NRS均值的差异为-0.52（P = 0.006），所有评估的差异为-0.86（P < 0.001）。在所有评估中，随着疼痛严重程度的增加，VAS和NRS评分之间的差异减小（P = 0.027），但初始评估时并非如此。在患有SCD的儿科患者中，发现VAS和NRS评分呈共同趋势；然而，在所有评估中发现VAS评分显著低于NRS评分。两种测量方法之间的一致性在疼痛严重程度增加时有所改善。这些发现表明，VAS和NRS相似，但在评估SCD患者的自我报告疼痛时不能互换使用。
