Scientific/Clinical Article| Volume 24, ISSUE 4, P356-364, October 2011

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Validity, Reliability, and Responsiveness of a Digital Version of the Visual Analog Scale

Published:August 08, 2011DOI:


      The design used in this study was a prospective cohort. Pain intensity levels recorded by the digital version of the visual analog scale (VAS-D) are easy to both score and share with other health care professionals. The purpose of the study was to examine the test–retest reliability, concurrent validity, and responsiveness of the VAS-D. Thirty-three people with upper extremity injuries reported pain intensity levels before and after performing four maximal grip contractions (pre- and postgripping). Our version of the VAS-D had high test–retest reliability (r=0.96) and good concurrent validity (r=0.84–0.97) with both the paper version of the VAS (VAS-P) and the verbal numerical rating scale (NRS-V). Responsiveness of the VAS-D was indicated by a significant increase in pain levels from pre- to postgripping. Similar responsiveness to that of the VAS-P and NRS-V was indicated by similar effect size coefficients and analysis of variance of pain change scores. In conclusion, the VAS-D is a reliable, valid, and responsive measure of pain intensity for people with upper extremity injuries. However, differences in accuracy (resolution) among the VAS-D, VAS-P, or NRS-V may render the three pain scales not fully compatible.

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      JHT Read for Credit

      Quiz: Article #206

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • #1.
        Which of the following is NOT TRUE regarding responsiveness?
        • a.
          responsiveness of an assessment means its ability to detect clinically meaningful change over time
        • b.
          a common statistical method used to calculate responsiveness is effect size (ES)
        • c.
          similar effect size (ES) coefficients between two pain scales indicate no difference in the ability of these scales to measure change in pain
        • d.
          smaller effect size (ES) coefficients indicate greater responsiveness
      • #2.
        In this study, test-retest reliability was determined by calculating
        • a.
          Pearson moment correlation coefficients
        • b.
        • c.
          Intraclass correlation coefficients (ICCs)
        • d.
      • #3.
        A key result was that the digital VAS model was
        • a.
          responsive, reliable, and valid
        • b.
          responsive but not valid because it was not reliable
        • c.
          reliable and valid but not responsive
        • d.
          too difficult to administer to render it clinically useful
      • #4.
        Pain was assessed
        • a.
          while a noxious stimulus (pin prick) was applied
        • b.
          pre and post gripping
        • c.
          at the conclusion of treatment
        • d.
          at the beginning of treatment
      • #5.
        The authors concluded that the 3 pain scales that were compared were essentially all very compatible
        • a.
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.