DOCSLIB.ORG

Measurement Properties of Visual Analogue

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Measurement Properties of Visual Analogue VU Research Portal Measurement Properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity Subscale of the Brief Pain Inventory in Patients With Low Back Pain Chiarotto, Alessandro; Maxwell, Lara J.; Ostelo, Raymond W.; Boers, Maarten; Tugwell, Peter; Terwee, Caroline B. published in Journal of Pain 2019 DOI (link to publisher) 10.1016/j.jpain.2018.07.009 document version Publisher's PDF, also known as Version of record document license Article 25fa Dutch Copyright Act Link to publication in VU Research Portal citation for published version (APA) Chiarotto, A., Maxwell, L. J., Ostelo, R. W., Boers, M., Tugwell, P., & Terwee, C. B. (2019). Measurement Properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity Subscale of the Brief Pain Inventory in Patients With Low Back Pain: A Systematic Review. Journal of Pain, 20(3), 245-263. https://doi.org/10.1016/j.jpain.2018.07.009 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal ? Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. E-mail address: [email protected] Download date: 30. Sep. 2021 The Journal of Pain, Vol 20, No 3 (March), 2019: pp 245−263 Available online at www.jpain.org and www.sciencedirect.com Critical Review Measurement Properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity Subscale of the Brief Pain Inventory in Patients With Low Back Pain: A Systematic Review AlessandroD1XX Chiarotto,*D2XX,y LaraD3XX J. Maxwell,D4XzXRaymondD5XX W. Ostelo,*D6XX,y MaartenD7XX Boers,*D8XX,x PeterD9XX Tugwell,D10XzX,{ and CarolineD1XX B. Terwee*D12XX *Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands. yDepartment of Health Sciences, Amsterdam Movement Sciences Research Institute, Vrije Universiteit, Amsterdam, Netherlands zCentre for Practice-Changing Research, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada. xAmsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, Netherlands. {Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada. Abstract: The Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), and Pain Severity sub- scale of the Brief Pain Inventory (BPI-PS) are the most frequently used instruments to measure pain intensity in low back pain. However, their measurement properties in this population have not been reviewed systematically. The goal of this study was to provide such systematic evi- dence synthesis. Six electronic sources (MEDLINE, EMBASE, CINAHL, PsycINFO, SportDiscus, Goo- gle Scholar) were searched (July 2017). Studies assessing any measurement property in patients with nonspecific low back pain were included. Two reviewers independently screened articles and assessed risk of bias using the COSMIN checklist. For each measurement property, evidence quality was rated as high, moderate, low, or very low (GRADE approach) and results were classi- fied as sufficient, insufficient, or inconsistent. Ten studies assessed the VAS, 13 the NRS, 4 the BPI-PS. The 3 instruments displayed low or very low quality evidence for content validity. High- quality evidence was only available for NRS insufficient measurement error. Moderate evidence was available for NRS inconsistent responsiveness, BPI-PS sufficient structural validity and inter- nal consistency, and BPI-PS inconsistent construct validity. All VAS measurement properties were underpinned by no, low, or very low quality evidence; likewise, the other measurement proper- ties of NRS and BPI-PS. Perspectives: Despite their broad use, there is no evidence clearly suggesting that one among VAS, NRS, and BPI-PS has superior measurement properties in low back pain. Future adequate quality head-to-head comparisons are needed and priority should be given to assessing content validity, test-retest reliability, measurement error, and responsiveness. © 2018 by the American Pain Society Key words: Low back pain, pain intensity, visual analogue scale, numeric rating scale, Brief Pain Inventory. Supported by the Task Force for Research of the Spine Society of Europe Address reprint requests to Alessandro Chiarotto, Department of Epide- (EUROSPINE) [grant number: EUROSPINE TFR 5-2015]. These funding miology and Biostatistics, Amsterdam Public Health research institute, bodies did not have any role in in designing the study, in collecting, ana- Amsterdam Movement Sciences research institute, VU University Medi- lyzing and interpreting the data, in writing this manuscript, and in cal Center, de Boelelaan 1089a, Medical Faculty F-vleugel, 1081HV, deciding to submit it for publication. Amsterdam, the Netherlands. E-mail: [email protected] The authors have no conflicts of interest to declare. 1526-5900/$36.00 Supplementary data accompanying this article are available online at © 2018 by the American Pain Society www.jpain.org and www.sciencedirect.com. https://doi.org/10.1016/j.jpain.2018.07.009 245 246 The Journal of Pain Measurement Properties of the VAS, NRS, and BPI-PS in LBP ow back pain (LBP) is the most disabling health Delphi study to reach consensus on which core out- condition worldwide.33 Measuring the impact of come measurement instrument(s) to endorse for pain LLBP on patients’ lives is fundamental to monitor- intensity in LBP clinical trials.8 For this reason, in con- ing clinical management and to study the (cost) effec- trast with previous reviews that had a more generic tiveness of treatments.4 Patients with LBP have focus on various pain conditions,6,42,47,52,86,94,108 this indicated that the most important domains to be mea- review focused solely on studies in patients with LBP, sured are physical functional activities, pain reduction, following the approach adopted in Cochrane reviews quality of life, enjoyment of life, emotional well-being, of randomized clinical trials on the effectiveness of and fatigue.9,43,103 A core outcome set initiative (involv- interventions in patients with LBP.32 ing patients) aimed at standardizing measurement for LBP identified 4 core outcome domains for clinical trials: physical functioning, pain intensity, health-related qual- Methods 9 ity of life, and number of deaths. Among these This systematic review was conducted according to domains, pain intensity is the most frequently assessed COSMIN guidance84 and reported according to the 31 in LBP clinical trials. PRISMA statement.71 Its protocol was registered in Pain intensity, defined as “how much a patient the international prospective register of systematic hurts, reflecting the overall magnitude of the pain reviews (http://www.crd.york.ac.uk/PROSPERO/), regis- 102 experience,” is the pain domain that ranked the tration number: CRD42015020006. highest among various pain domains (eg, pain qual- ity, temporal aspects of pain, pain behavior, and pain Measurement Instruments interference) in consensus exercises to establish core The VAS is a self-reported scale consisting of a hori- outcome domains for LBP9 and other pain condi- zontal or vertical line, usually 10 cm long (100 mm) tions.53,77 The visual analogue scale (VAS) is the anchored at the extremes by 2 verbal descriptors refer- patient-reported outcome measure (PROM) most fre- ring to the pain status.45 An introductory question (with quently used to measure pain intensity in LBP trials, or without a time recall period) asks the patient to tick followed by the numeric rating scale (NRS) and the the line on the point that best refers to his or her pain. Pain Severity subscale of the Brief Pain Inventory The introductory question, the recall period, and the (BPI-PS).7,31 Recent consensus-based studies have content of the external verbal descriptors vary in the shown that researchers and clinicians prefer the NRS literature.39 over other instruments to measure pain intensity in The NRS is a numbered version of the VAS in which LBP.13,17,22,24 However, this choice has not been the patient can select one number that best describes explicitly based on its measurement properties and the pain.23 Like in the VAS, the NRS introductory ques- feasibility.5,85 tion, time recall period and verbal descriptors can vary; The NRS, VAS, and BPI-PS are highly feasible for the most frequently used version is the 11-point (0-10) clinical research and practice, providing very little NRS.39 burden to professionals and patients.39 Various The BPI-PS consists of four 11-point NRSs, two of reviews have attempted to synthesize their measure- which asking the patient to rate the pain at its worst ment properties in samples of patients with and least in the last 24 hours, and the other two asking pain.6,42,47,52,86,94,108 All these reviews focused on about pain on the average and right now.15 For each chronic pain broadly and two of them solely focused NRS, the verbal descriptors are no pain and
Load more

Recommended publications
  • Gabapentin for the Management of Chronic Pelvic Pain in Women
    Archives of Gynecology and Obstetrics (2019) 300:1271–1277 https://doi.org/10.1007/s00404-019-05272-z GENERAL GYNECOLOGY Gabapentin for the management of chronic pelvic pain in women M. A. AbdelHafeez1 · A. Reda1 · A. Elnaggar1 · H. EL‑Zeneiny1 · J. M. Mokhles1 Received: 4 March 2019 / Accepted: 8 August 2019 / Published online: 21 August 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Background Chronic pelvic pain (CPP) is a frequent presenting symptom in gynaecology outpatient clinics. Neuromodulator pharmacological agents could be an option for treatment based on its efcacy in treating chronic pain in other conditions. Purpose This study aimed at evaluating the efcacy of oral Gabapentin to alleviate pain in women with CPP. Methods In a randomized double-blinded placebo-controlled trial, 60 women sufering from chronic pelvic pain were ran- domly divided into two equal arms. The study group received Gabapentin 300 mg three times daily initially (900 mg), with 300 mg weekly incremental dose till pain was controlled, severe side efects occurred or maximum daily dose of 2700 mg was reached. The Primary outcome was the pain score improvement of CPP, defned as a 30% reduction in the pain score assessed by the 10-cm Visual Analogue Scale compared to baseline score. Results In Gabapentin group, pain was signifcantly reduced at 12 and 24 weeks (mean = 5.12 ± 0.67 and 3.72 ± 0.69, respec- tively) than in placebo group (mean = 5.9 ± 0.92 and 5.5 ± 1.13, respectively); this diference was signifcant. At 24 weeks, there was signifcantly higher proportion of patients reporting 30% or more reduction in pain scores; 19 out of 20 patients (95%) in Gabapentin group compared to 8 out of 14 patients (57.1%) in placebo group.
    [Show full text]
  • Needle-Free Electroacupuncture for Postoperative Pain Management
    Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2011, Article ID 696754, 7 pages doi:10.1155/2011/696754 Research Article Needle-Free Electroacupuncture for Postoperative Pain Management Daniel Lee,1 Hong Xu,1 Jaung-Geng Lin,2 Kerry Watson,1 Rick Sai Chuen Wu,2 and Kuen-Bao Chen2 1 School of Biomedical and Health Sciences, Victoria University, Melbourne, VIC 8001, Australia 2 Department of Anesthesiology, China Medical University Hospital, Taichung 40447, Taiwan Correspondence should be addressed to Hong Xu, [email protected] Received 17 January 2011; Accepted 24 March 2011 Copyright © 2011 Daniel Lee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This study examined the effects of needle-free electroacupuncture, at ST36 on postoperative pain following hysterectomy. Based on a double-blind, sham and different intervention controlled clinical experimental design, 47 women were randomly allocated to four different groups. Except for those in the control group (Group 1, n = 13), a course of treatment was given of either sham (Group 2, n = 12), high-frequency stimulation (Group 3, n = 12), or low-frequency stimulation (Group 4, n = 10). All groups were assessed during the postoperative period for 24 hours. The Visual Analogue Scale was used to determine the amount of perceived pain felt by each subject. Differences were found between the means postoperatively at three, four, eight, 16 and 24 hours. Post hoc comparison tests indicated that Group 4 was significantly different from Groups 1, 2, and 3 at 24 hours.
    [Show full text]
  • The Use of Box-Counting Method in the Interpretation of Visual Analogue Scale Scores
    The use of box-counting method in the interpretation of Visual Analogue Scale scores Thamer Ahmad A.K. Altaim1*, A.A. LeRoux2 1 Physiotherapy Department, College of Applied Medical Sciences in Qurayyat, Jouf University, Post code: 77454, Saudi Arabia. 2Longhand Data Limited, Wellburn, York, YO60 7EP, United Kingdom. Correspondence: Thamer Ahmad Abdul Kareem Altaim. Physiotherapy Department, College of Applied Medical Sciences in Qurayyat, Jouf University, Post code: 77454, Saudi Arabia. Email: [email protected]. ABSTRACT Clinicians in their clinical practices face great amounts of difficulties interpreting scores obtained from the pain outcome measures. In spite of long-standing critiques of visual analogue scales (VAS) for pain, no alternative method of measurement has been proposed, and researchers and clinicians have had no alternative to continue using this scale. This study proposed a method which would provide valid measurements on a VAS, one of the most commonly used outcome measures with a particular reference to the 10-cm version of VAS for pain. The method was the box-counting method. The integration of this new method in the interpretations of a patient’s sensation of pain would not only enable clinicians interpret measurements, but also it would help in planning or delivering treatments. The proposed method provided the certainty of the accuracy of a clinical interpretation of a score on the scale. Keywords: Pain outcome measure, visual analogue scale, box-counting method. using the 10-cm Visual Analogue Scale for Pain. Problems in Introduction doing so arise from the uncertainty of the accuracy of a clinical interpretation of a score on the scale.
    [Show full text]
  • 11 Abstract Efficacy of Transcutaneous Electrical
    EFFICACY OF TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) IN TREATMENT OF NEUROPATHIC PAIN IN PATIENTS WITH DIABETIC NEUROPATHY Anjan Desai1, Khushbu Desai2 ijcrr 1SPB Physiotherapy College, Surat, Gujarat Vol 04 issue 09 2Nanduba Medical Centre, Surat, Gujarat Category: Research Received on:12/04/12 Revised on:16/04/12 E-mail of Corresponding Author: [email protected] Accepted on:20/04/12 ABSTRACT Introduction: Diabetic Neuropathy is a peripheral nerve disorder caused by diabetes that leads to pain in periphery. Many patients are limited in their physical activity by pain. The study conducted to assess the effect of Transcutaneous Electrical Nerve Stimulation (TENS) application for reduction of pain in patients with diabetic neuropathy. Aim of study: The main objective of this study is to compare the effect of TENS on Diabetic Neuropathy patients in reduction of pain and improving single limb stance. Materials and Methodology: Study Design: An experimental comparative study. Sample Selection: A sample of 30 patients diagnosed as diabetic neuropathy were taken from after giving due consideration to inclusion and exclusion criteria. Sample size: Total 30 including Control Group (Group A): The patients in this group were given therapeutic exercise training only and Experimental Group (Group B): The patients in this group were given treatment with TENS application and therapeutic exercise training. Inclusive Criteria: Patients of diabetic neuropathy affecting unilateral lower limb defined as ≥ 50% loss of strength and sensation of foot relative to non-affected side and complain of pain duration ≥ 5 months. Exclusion Criteria: Patients with age group between the 50-60 years and Patients with other pathological conditions of foot i.e.
    [Show full text]
  • The Effect of Transcutaneous Electrical Nerve
    Short Communication Annals and Essences of Dentistry 2020 Vol.12 No.2 Dental Forum 2020: The effect of transcutaneous electrical nerve stimulation on pain control and anxiety reduction during dental procedure in children 9-14 year’s old - Nina Cebalo - University of Zagreb Nina Cebalo University of Zagreb, Croatia The aim of the study is to analyse the effusiveness of the measuring stress levels with stress-quesonnaires in patients will Transcutaneous Electrical Nerve Smulaon on in decreasing pain give a broader view of connected on and the impact of and anxiety during a dental procedure. The method of psychological stress on the manifestos of anxiety and pain Transcutaneous Electroneurosmula on is based on the principle control. of Electro analgesia, where smulaon of nerve fibers occurs. Smulaon of the A fibers blocks C fibers responsible for Pain has been unchanged tormentor of mankind since time transmission of pain at higher levels of the nervous system. immemorial. Techniques used to control pain are broadly Transcutaneous Electrical Nerve Simulator (TENS device) divided into pharmacological and non-pharmacological works on reduce on of acute and chronic pain, stress, tension, methods. Most common pharmacological means to curb pain in poor circular on and fatigue. Similarly, it can be used to manage dentistry is the use of local anesthesia during dental procedures pain during various dental procedures, as well as pain due to and analgesics for the postoperative pain. Use of local various conditions affecting the maxillofacial region. It can also anesthesia instills fear in a many patients as it requires the use be used as a distract on or placebo mechanism in order to of the ‘horrifying’ syringe.
    [Show full text]
  • Personalized Automatic Estimation of Self-Reported Pain Intensity from Facial Expressions
    Personalized Automatic Estimation of Self-reported Pain Intensity from Facial Expressions Daniel Lopez Martinez1;2, Ognjen (Oggi) Rudovic2 and Rosalind Picard2 1 Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology 2 MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA fdlmocdm,orudovic,[email protected] Abstract of pain, patient’s self-report provides the most valid mea- sure of this fundamentally subjective experience [28]. Var- Pain is a personal, subjective experience that is com- ious pain rating scales have been developed to capture pa- monly evaluated through visual analog scales (VAS). While tient’s self-report of pain intensity [16, 14]. The Visual Ana- this is often convenient and useful, automatic pain detec- logue Scale (VAS), Numerical Rating Scale (NRS), Verbal tion systems can reduce pain score acquisition efforts in Rating Scale (VRS), and Faces Pain Scale-Revised (FPS- large-scale studies by estimating it directly from the partic- R) are among the most commonly used scales. While evi- ipants’ facial expressions. In this paper, we propose a novel dence supports the reliability and validity of each of these two-stage learning approach for VAS estimation: first, our measures across many populations [11], each measure has algorithm employs Recurrent Neural Networks (RNNs) to strengths and weaknesses that make them more appropri- automatically estimate Prkachin and Solomon Pain Inten- ate for different applications [49]. In the research setting, sity (PSPI) levels from face images. The estimated scores for example, VAS is usually preferred since it is statistically are then fed into the personalized Hidden Conditional Ran- the most robust as it can provide ratio level data [49, 32], dom Fields (HCRFs), used to estimate the VAS, provided by allowing parametric tests to be used in statistical analysis.
    [Show full text]
  • The Use of the Visual Analogue Scale (VAS) in Rehabilitation Outcomes
    J Rehabil Med 2012; 44: 609–610 COMMENTARY The use of the Visual AnaloGue Scale (VAS) in Rehabilitation OUTCOMES The Visual Analogue Scale (VAS) is a common form of response not equally spaced (29). Svensson (30) also clearly placed the option in health outcome studies, often used to measure pain, VAS among ordinal scales. amongst other things, and is generally presented as a single line It was again in the predecessor of the Journal of Rehabilitation of 100 mm with anchor words at either end (e.g. no pain – worst Medicine, the Scandinavian Journal of Rehabilitation Medicine, possible pain). It was first published in the early 1920’s (1, 2) that the first empirical evidence was presented which clearly though not widely used at that time (3). There are variations demonstrated that the VAS was ordinal (31). Using Rasch analysis, on the VAS theme, sometimes with shorter lines (e.g. 65 mm), that study showed the non-linear nature of the VAS, whereby the and whatever the length, while they are typically presented in scale works just like any other ordinal scale. Since that time, other horizontal format, they can also be presented as vertical lines work has shown the same and, how misuse of VAS scales can, for (4), and the two forms of presentation have been considered as example, lead to the calculation of spurious effect sizes, which equivalent (5). Another alternative is where it is presented as a could affect outcomes from clinical trials, or sample size estimates thick line of blocks (looking much like bricks laid end-to-end) (32).
    [Show full text]
  • The Validation of Visual Analogue Scales As Ratio Scale Measures for Chronic and Experimental Pain
    Pain, 17 (1983) 45-56 45 Elsevier The Validation of Visual Analogue Scales as Ratio Scale Measures for Chronic and Experimental Pain Donald D. Price, Patricia A. McGrath *,I, Amir Rafii and Barbara Buckingham ~eparfment of AnaestkesioIogy, Medical College of Virginia, Richmond, Vu (U.S.A.) rind * ~ep~tment of Paediatrks, The University of Western Ontario, War Memoriai Children’s Hospital, London, Ont. N6B f3B (Canada) (Received 19 November 1982, accepted 21 February 1983) Visual analogue scales (VAS) of sensory intensity and affective magnitude were validated as ratio scale measures for both chronic and experimental pain. Chronic pain patients and healthy volunteers made VAS sensory and affective responses to 6 noxious thermal stimuli (43,45,47,48, 49 and Sl’C) applied for 5 set to the forearm by a contact thermode. Sensory VAS and affective VAS responses to these temperatures yielded power functions with exponents 2.1 and 3.8, respectively; these functions were similar for pain patients and for volunteers. The power functions were predictive of estimated ratios of sensation or affect produced by pairs of standard temperatures (e.g. 47 and 49*C), thereby providing direct evidence for ratio scaling properties of VAS. VAS sensory intensity responses to experimental pain, VAS sensory intensity responses to different levels of chronic pain, and direct temperature (experimental pain) matches to 3 levels of chronic pain were all internally consistent, thereby demonstrating the valid use of VAS for the measurement of and comparison between chronic pain and experimental heat pain. Introduction Assessments of human pain have evolved from a reliance on threshold and tolerance determinations of the intensity of pain to the use of a wide variety of psychological and physiological methods for scaling multiple dimensions of experi- ’ Send all correspondence to Dr.
    [Show full text]
  • A Novel, Regenerative Treatment Approach for Patients with Chronic
    A Novel, Regenerative Treatment Approach for Patients with Chronic Pelvic Pain Syndrome Utilizing Alpha-2 Macroglobulin Abigail Bayer-Mertens Human, Tayyaba Ahmed DO, Charity Hill MD, Gautam Shrikhande MD FACS, Allyson Shrikhande MD Pelvic Rehabilitation Medicine, New York NY Patients with chronic pelvic pain syndrome (CPPS) often have debilitating symptoms and decreased functionality related to their pelvic organs and pelvic floor musculature. CPPS is underdiagnosed and treatment options are not well researched. The objective of this study is to determine the effectiveness of alpha-2 macroglobulin therapy in patients with CPPS. One promising CPPS treatment is the usage of alpha-2 macroglobulin as a protease inhibitor to mitigate inflammation and pain. Alpha-2 macroglobulin, a regenerative, non-opioid treatment option, is a plasma glycoprotein which occurs naturally in humans. This retrospective study analyzed the effectiveness of alpha-2 macroglobulin in eleven patients, seven male and four female, with CPPS. Patients were aged 31- 59, and additionally had diagnoses ranging from central pain syndrome, interstitial cystitis and endometriosis. Patients were initially evaluated with a detailed history and physical exam, including internal pelvic floor evaluation. All patients had unsuccessfully attempted other treatments for their pain in the past. Patient’s scores on the Visual Analogue Scale (VAS) and Functional Pelvic Pain Scale (FPPS) were collected pre-treatment and 12 weeks post-treatment. The FPPS is a scale which measures 8 categories (bladder, bowel, intercourse, walking, sleeping, working, running and lifting) to determine a patient’s functionality in relation to their pelvis. The scale rates each category from 0 to 4, with 0 being normal and 4 being most debilitating.
    [Show full text]
  • 2019 Symposium 2 Individual Abstracts – Morning Session
    1 2019 Symposium 2 Individual Abstracts – Morning Session 3 WORKING WITH TURTLE IMMUNE CELLS AND ANTIBODIES IN THE LAB: 4 DETERMINING EXPERIMENTAL CONDITIONS 5 Presenter Abbott, Ceara 6 Undergraduate, Biological Sciences 7 Mentor Prof. Laura Vogel 8 Co-Mentor Prof. Rachel Bowden 9 Authorship Ceara Abbott; Paige Farchmin; Beto Araiza; Rachel Bowden; 10 Laura Vogel 11 12 While much is known about the human immune system, we don't know much about reptilian immune responses. Turtles have 13 long life spans and certainly their immune system contributes to their longevity. Our lab is interested in how turtle immunity 14 works, so we performed experiments to test how turtle white blood cells reacted in common immune assays. 15 16 First, we determined if turtle cells could be analyzed and sorted on our new cell-sorting instrument, the FACSMelody. As the 17 instrument has different filters for different size cells, we first determined which filter to use during analysis. Our hypothesis was 18 that the larger turtle cells would appear properly using the 2.0 filter. We analyzed cells run on 1.0, 1.5 and 2.0 filters. We did find 19 that turtle cells were larger in size and need the 2.0 filter. 20 21 Next, we needed to determine if turtle cells would survive the cell sorting process on the instrument. We hypothesized the 22 newer and faster sorting technology on the FACSMelody would increase cell survival. We predicted that turtle B cells would be 23 able to survive the sorting. Turtle immune cells were run and sorted into B cell and non-B cell populations.
    [Show full text]
  • The Visual Analog Scale for Pain Clinical Significance in Postoperative Patients Carol A
    Anesthesiology 2001; 95:1356–61 © 2001 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc. The Visual Analog Scale for Pain Clinical Significance in Postoperative Patients Carol A. Bodian, Dr.P.H.,* Gordon Freedman, M.D.,† Sabera Hossain, M.S.,§ James B. Eisenkraft, M.D.,ʈ Yaakov Beilin, M.D.‡ Background: The visual analog scale is widely used in re- able.” Its simplicity, reliability, and validity, as well as its search studies, but its connection with clinical experience out- ratio scale properties, make the VAS the optimal tool for side the research setting and the best way to administer the VAS describing pain severity or intensity.1 forms are not well established. This study defines changes in dosing of intravenous patient-controlled analgesia as a clini- There remain some outstanding questions regarding Downloaded from http://pubs.asahq.org/anesthesiology/article-pdf/95/6/1356/333546/0000542-200112000-00013.pdf by guest on 26 September 2021 cally relevant outcome and compares it with VAS measures of the use of the VAS in research studies. We address three postoperative pain. of these in this report. First, an optimal connection Methods: Visual analog scale measurements were obtained between VAS values and clinical experience outside the from 150 patients on the morning after intraabdominal sur- research setting is not well established. Certain differ- gery. On the same afternoon, 50 of the patients provided a VAS score on the same form used in the morning, 50 on a new form, ences between groups in their VAS scores or changes in and 50 were not asked for a second VAS measurement.
    [Show full text]
  • Basics of Pain Assessment and Management
    Basics of Pain Assessment and Management Updated May 20, 2019 1 PAMI learning module content will sometimes overlap due to similar topics. The PAMI website offers access to learning module handouts, PAMI Pain Management and Dosing Guide, resources, toolkits, best practices and recent pain news. We welcome your feedback on all PAMI materials and are interested in how you use them to improve patient safety, pain education and clinical care. Please email [email protected] For more information please visit http://pami.emergency.med.jax.ufl.edu/ Like Us on Facebook at https://goo.gl/4Yh1cB Follow Us on Twitter @pami_painmgmt 2 Presentation Information • An electronic pdf version of this document is available on the PAMI website http://pami.emergency.med.jax.ufl.edu/resources/pami- module-downloads/ • All PAMI created materials are free access and can be utilized for educational programs or adapted to institutional needs. • Suggested Citation: Basic of Pain Assessment and Management. University of Florida College of Medicine - Jacksonville, Department of Emergency Medicine. Pain Assessment and Management Initiative (PAMI 3.0): Multimodal Approaches to Improve Pain Outcomes and Reduce Opioid Risk, [date retrieved]. Retrieved from http://pami.emergency.med.jax.ufl.edu/. 3 Disclaimer The PAMI website, learning modules, and resources are for educational and informational purposes only. The PAMI website is not intended as a substitute for professional medical diagnosis or management by a qualified health care professional. PAMI is not responsible for any legal action taken by a person or organization as a result of information contained in or accessed through this website, whether such information is provided by PAMI or by a third party.
    [Show full text]