Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
J Am Acad Dermatol. 2020 Jan;82(1):80-86. doi: 10.1016/j.jaad.2019.06.043. Epub 2019 Jun 27.
Several tools can provide a reliable and accurate evaluation of pruritus, including the visual analog scale (VAS), numeric rating scale (NRS), verbal rating scale (VRS), and multidimensional questionnaires such as the Itch Severity Scale (ISS). However, no single method is considered a gold standard.
We evaluated the validity and reliability of VAS, NRS, VRS, and ISS and their correlation with a pruritus-specific quality of life instrument, ItchyQoL.
A total of 419 patients (215 men and 204 women) with chronic pruritus (mean age, 46.58 years) recorded their pruritus intensity on VAS, NRS, VRS, and ISS. Retest reliability was analyzed in a second assessment 3 hours after the initial assessment. All participants answered ItchyQoL.
A strong correlation between VAS, NRS, and VRS was found. ISS showed a low intercorrelation validity with these tools. However, ISS was more strongly correlated with ItchyQoL. The retest reliability scores were similar for VAS, NRS, and VRS but lower than the scores obtained for ISS.
Limitations include patient heterogeneity and recall bias.
The assessment of pruritus is challenging because of the subjective symptoms and the multifactorial nature. Therefore, more studies are needed to determine the best strategy to assess itch intensity.
有几种工具可以对瘙痒进行可靠和准确的评估，包括视觉模拟评分法（VAS）、数字评分法（NRS）、言语评分法（VRS）和多维问卷，如瘙痒严重程度量表（ISS）。然而，没有一种单一的方法被认为是金标准。
我们评估了 VAS、NRS、VRS 和 ISS 的有效性和可靠性，以及它们与瘙痒特异性生活质量工具 ItchyQoL 的相关性。
共有 419 名患有慢性瘙痒的患者（215 名男性和 204 名女性，平均年龄 46.58 岁）使用 VAS、NRS、VRS 和 ISS 记录他们的瘙痒强度。在初始评估 3 小时后进行第二次评估，分析重测信度。所有参与者均回答了 ItchyQoL。
VAS、NRS 和 VRS 之间存在很强的相关性。ISS 与这些工具的相关性较低。然而，ISS 与 ItchyQoL 的相关性更强。VAS、NRS 和 VRS 的重测信度评分相似，但低于 ISS 的评分。
局限性包括患者异质性和回忆偏倚。
由于瘙痒的主观症状和多因素性质，对瘙痒的评估具有挑战性。因此，需要更多的研究来确定评估瘙痒强度的最佳策略。
