Clinically relevant VAS pain score change in patients with acute rheumatic conditions.
BACKGROUND
Pain assessment is a crucial step in the management of patients with rheumatic diseases. Among validated pain scores, the visual analog scale (VAS) score is the most widely used, in both clinical practice and therapeutic trials.


OBJECTIVE
To determine the VAS pain score decrease that constitutes meaningful pain relief, with the goal of evaluating treatment effects.


METHODS
We included patients with acute pain caused by non-malignant rheumatic conditions. Pain duration of less than 1month and a baseline VAS score greater than 50/100mm were required. Twice daily, patients evaluated pain intensity using the VAS and pain relief using a five-category verbal rating scale (VRS) where 0 indicated no pain relief and 4 excellent relief.


RESULTS
Fifty patients were included. VAS score changes correlated linearly with VRS score changes (r=0.7 and P<0.001). A one-category improvement on the VRS was associated with a 20-mm decrease in the VAS score (P<0.0001) and a two-category improvement with a 40-mm decrease (P<0.0003).


CONCLUSIONS
The dearth of published data on clinically relevant VAS pain score changes in patients with acute rheumatic pain requires further studies, in order to improve patient care and the comparability of therapeutic trials.
Grilo
Rose Marie
RM
Paris 5 University, School of Medicine, Rheumatology A Department, Cochin Teaching Hospital, APHP, Paris, France.
Treves
Richard
R
Preux
Pierre Marie
PM
Vergne-Salle
Pascal
P
Bertin
Philippe
P
D000208:Acute Disease; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold; D010148:Intractable Pain / Q000175:diagnosis*; D011336:Probability; D015203:Reproducibility of Results; D012216:Rheumatic Diseases / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index