Visual analog scales

To monitor efficacy, the patient s baseline pain can be assessed with a visual analog scale, and range of motion for affected joints can be assessed with flexion, extension, abduction, or adduction. 

Initially, anxious patients should be monitored once to twice weekly for reduction in anxiety symptoms, improvement in functioning, and side effects. The Visual Analog Scale may assist in the evaluation of drug response. 

For reasons of expediency and objectivity, and particularly in the case of more extensive studies, questions are preferably submitted in writing, i.e. in some form of self-rating scale. Here one can distinguish between symptom checklists, adjective checklists, semantic differentials and visual analog scales. 

Figure 9.1 Visual analog scale for cost-utility analysis...

In 2000 Hamilton et al. reported that ATP in human skin elicits a dose-related pain response which is potentiated under conditions of hyperalgesia. The authors used iontophoresis to deliver ATP to the forearm skin of volunteers who rated the magnitude of the evoked pain on a visual analog scale. ATP consistently produced a modest burning pain, which began within 20 s. of starting iontophoresis and was maintained for several minutes. Persistent iontophoresis of ATP led to desensitization... 

Subjective effects of the experimental drugs were estimated from scores on several standardized tests and computer-delivered 100-mm visual analog scales that measured drug symptoms, strength and liking. The 100-mm scale was anchored with the terms not at all (0 mm) and extremely (100 mm). The subjects rated subjective effects at about the same times of the pupillary measures. 

This study involved 75 patients, 36 in the active group and 36 in the placebo group 3 patients were excluded because of insufficient data. The mean age of patients was 25 years. The study was conducted double-blind versus placebo for 2 years. The criterion for inclusion was rhinitis with or without asthma. The efficacy criteria were skin tests, a diary kept daily of symptoms and treatments, the assessment of nasal symptoms only, assessment of rhinitis using a visual analog scale by the patient and by the doctor, and assay of specific IgE and specific IgG4 versus mites. 

A visual analog scale can be used for sleepiness, and is similar to what is commonly used in the assessment of pain. It typically uses a horizontal line (e.g., 10 cm), on which subjects can draw a vertical mark indicating their degree of alertness or sleepiness. In theory this provides a continuous measure, rather than a discrete integer. This is probably overly simplistic to measure a multidimensional and complex phenomenon like sleepiness. It does not add much to simple history taking, and is overall rarely used (3,4). 

Perhaps the most common type of verbal report used in sleep deprivation studies is a measure of subjective sleepiness. Subjective sleepiness is generally assessed by self-report scales (see also Chap. 1), such as the Stanford Sleepiness Scale (19), the Epworth Sleepiness Scale (20), visual analog scales (21), and the vigor and fatigue subscales on the Profile of Mood States (POMS Educational and Industrial Testing Service, San Diego, CA). These measures have been used in studies on the effects of sleep deprivation (22-25), shift work (26-28), and sleep disorders (29,30). 

Riker, R.R. Fraser, G.L. Simmons, L.E. Wilkins, M.L. Validating the sedation-agitation scale with the bi.spcctral index and visual analog scale in adult ICU patients after cardiac surgery. Intensive Care Med. 2001, 27, 853-858. 

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