Dear Paul and others,
Surely the VAS is certainly more reliable than the "getting better" as
quoted in a previous listing. At least the VAS is a more scientific way to
measure improvement of pain as compared to the statement "getting better".
Regards,
VERNON LEVER (BSc.Hons. N.D.Pod.S.A.)
P.O.BOX 751380
Gardenview 2047
Gauteng
South Africa
Tel: W) 011-622-4680
Cellular phone: 082-410-5249
E-mail: [log in to unmask]
----- Original Message -----
From: "Joel Radford" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, September 07, 2004 9:55 AM
Subject: Re: BJP Paper and Orthotic Evaluation
Dear Paul,
Yes, I agree that the patients in the ESWT trial have not improved by
treatment.
However, your statement that the "VAS is a very crude method of measuring
anything" may not be accurate. I'd be interested in the references of the
studies you're referring to.
As far as I know, the VAS has long been accepted as reliable and valid
measure, particularly for pain:
- Revill et al (1976) found in 39 participants high correlations between
measurements of remembered pain (r=0.97 to 0.99).
- Scott and Huskisson (1976) demonstrated that the VAS does not differ
significantly from a uniform distribution when 100 patients were assessed
for pain.
-And Price et al (1983) demonstrated high between session reliability
(r=0.97) for 50 participants who received pain evoked by heat pulses. In
addition 30 of these participants had chronic back pain and were able to
easily scale the intensity of their pain at its minimal (20mm), usual (49mm)
and maximal levels (72mm) on a 15mm VAS.
-Also, the frequent use of the VAS in clinical trials across most medical
fields demonstrates its apparent responsiveness to change.
If anyone is interested in what change on a visual analogue scale is needed
before a patient can be seen to be improving I could provide some references
for that too.
Kind regards,
Joel.
Price, D. D., P. A. McGrath, et al. (1983). "The Validation of Visual
Analogue Scales as Ratio Scale Measures for Chronic and Experimental Pain."
Pain 17: 45-56.
Revill, S. I., J. O. Robinson, et al. (1976). "The reliability of a linear
analogue for evaluating pain." Anaesthesia 31: 1191-1198.
Scott, J. and E. C. Huskisson (1976). "Graphic representation of pain." Pain
2: 175-184.
-----Original Message-----
From: A group for the academic discussion of current issues in podiatry
[mailto:[log in to unmask]]On Behalf Of Paul Conneely
Sent: Sunday, 5 September 2004 5:56 PM
To: [log in to unmask]
Subject: Re: BJP Paper and Orthotic Evaluation
Dear All
The VAS is a very crude method of measuring anything. Studies regarding
the reliability and Validity of VAS and thus accuracy of the VAS indicate
that this measuring method is 'crude' at best.
A P value of 0.04 suggests that there is a 4% probability that chance is
involved in the treatment, that is they got better of their own accord.
When applying the miniscule changes to the VAS that these patients have
over three month period, one can conclude that they have not improved by
treatment but by time.
Paul Coneely.
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