PMID- 29243996
OWN - NLM
STAT- MEDLINE
DCOM- 20190404
LR  - 20220410
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 28
IP  - 3
DP  - 2018 Mar
TI  - Validation of the visual analog scale in the cervical spine.
PG  - 227-235
LID - 2017.5.SPINE1732 [pii]
LID - 10.3171/2017.5.SPINE1732 [doi]
AB  - OBJECTIVE The visual analog scale (VAS) is frequently used to measure treatment 
      outcome in patients with cervical spine disorders. The minimum clinically 
      important difference (MCID) is the smallest change in a score that has clinical 
      importance to the patient. Although it has been established for other medical 
      fields, knowledge of the VAS MCID for the cervical spine is sparse, and it has 
      rarely been considered in relation to measurement noise. The goals in this study 
      were as follows: 1) to validate the VAS-neck and VAS-arm instruments for the 
      cervical spine (e.g., repeatability); 2) to investigate the possible influence of 
      predictive factors and the Hospital Anxiety and Depression Scale (HADS) score on 
      repeatability; and 3) to compute the MCID with 5 different methods. METHODS A 
      post hoc analysis of a prospective randomized controlled trial with 151 patients 
      undergoing surgery for cervical radiculopathy due to degenerative disc disease 
      was performed. Information on age, sex, smoking habits, exercise, employment 
      status, HADS score, and VAS-neck and VAS-arm scores was gathered before surgery 
      and after 1 year. The VAS was applied twice on every occasion, with 15 minutes in 
      between. Repeatability and the association with predictors and HADS score were 
      analyzed using the 1-sample t-test, linear regression models, and Spearman 
      correlation. The MCID was calculated with the following methods: average change, 
      change difference, receiver operating characteristic curve, effect size, and 
      minimum detectable change (MDC). RESULTS The repeatability in VAS-neck was 8.1 
      mm, and in VAS-arm it was 10.4 mm. Less consistent values on the VAS correlated 
      to female sex and higher values on the HADS. For VAS-neck the MCID ranged from 
      4.6 to 21.4, and for VAS-arm it ranged from 1.1 to 29.1. The highest MCID came 
      from the MDC method, which was the only method that gave values above the 
      measurement noise in both VAS-neck and VAS-arm. CONCLUSIONS Measurement noise in 
      VAS-neck and VAS-arm for the cervical spine was influenced by female sex and HADS 
      score. The only method to compute MCID that consistently gave results above the 
      measurement noise in VAS-neck and VAS-arm was the MDC. Clinical trial 
      registration no.: 44347115 ( www.isrctn.com ).
FAU - MacDowall, Anna
AU  - MacDowall A
AD  - 1Department of Surgical Sciences, Uppsala University Hospital, Uppsala; and.
FAU - Skeppholm, Martin
AU  - Skeppholm M
AD  - 2Department for Learning, Informatics, Management and Ethics, Karolinska 
      Institutet, Stockholm, Sweden.
FAU - Robinson, Yohan
AU  - Robinson Y
AD  - 1Department of Surgical Sciences, Uppsala University Hospital, Uppsala; and.
FAU - Olerud, Claes
AU  - Olerud C
AD  - 1Department of Surgical Sciences, Uppsala University Hospital, Uppsala; and.
LA  - eng
SI  - ISRCTN/ISRCTN44347115
PT  - Journal Article
PT  - Validation Study
DEP - 20171215
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
MH  - Adult
MH  - Cervical Vertebrae/*surgery
MH  - Disability Evaluation
MH  - Female
MH  - Humans
MH  - Intervertebral Disc Degeneration/*surgery
MH  - Male
MH  - Middle Aged
MH  - *Pain Measurement/methods
MH  - Radiculopathy/surgery
MH  - *Randomized Controlled Trials as Topic
MH  - Spinal Fusion/methods
MH  - Treatment Outcome
MH  - *Visual Analog Scale
OTO - NOTNLM
OT  - CI = confidence interval
OT  - DDD = degenerative disc disease
OT  - HADS = Hospital Anxiety and Depression Scale
OT  - Hospital Anxiety and Depression Scale
OT  - MCID = minimum clinically important difference
OT  - MDC = minimum detectable change
OT  - PROM = patient-reported outcome measures
OT  - ROC = receiver operating characteristic
OT  - SD = standard deviation
OT  - SEM = standard error of measurement
OT  - VAS = visual analog scale
OT  - cervical degenerative disc disease
OT  - minimum clinically important difference
OT  - surgical treatment
OT  - visual analog scale
EDAT- 2017/12/16 06:00
MHDA- 2019/04/05 06:00
CRDT- 2017/12/16 06:00
PHST- 2017/12/16 06:00 [pubmed]
PHST- 2019/04/05 06:00 [medline]
PHST- 2017/12/16 06:00 [entrez]
AID - 2017.5.SPINE1732 [pii]
AID - 10.3171/2017.5.SPINE1732 [doi]
PST - ppublish
SO  - J Neurosurg Spine. 2018 Mar;28(3):227-235. doi: 10.3171/2017.5.SPINE1732. Epub 
      2017 Dec 15.