title: Validation and properties of the verbal numeric scale in children with acute pain.
abstract: Although the verbal numeric scale (VNS) is used frequently at patients' bedsides, it has never been formally validated in children with acute pain. In order to validate this scale, a prospective cohort study was performed in children between 8 and 17years presenting to a pediatric emergency department (ED) with acute pain. Pain was graded using the VNS, the visual analogue scale (VAS), and the verbal rating scale (VRS). A second assessment was done before discharge. We determined a priori that in order to be valid, the VNS would need to: correlate with the VAS (concurrent validity); decrease after intervention to reduce pain (construct validity); and be associated with the VRS categories (content validity). The VNS interchangeability with the VAS, its minimal clinically significant difference, and test-retest reliability were also determined. A total of 202 patients (mean age: 12.2+/-2.6years) were enrolled. The VNS correlated with the VAS: r(ic)=0.93, p<0.001. There were differences in the VNS before versus after interventions (p<0.001), and between VRS categories (mild versus moderate, p<0.001; moderate versus severe, p<0.001). The 95% limits of agreement (interchangeability) between VNS/VAS were outside the a priori set limit of +/-2.0: -1.8, 2.5. The VNS minimal clinically significant difference was 1. The VNS had good test-retest reliability with 95% limits of agreement of -0.9 and 1.2. In conclusion, the VNS provides a valid and reliable scale to evaluate acute pain in children aged 8-17years but is not interchangeable with the VAS.
authors.affiliation: Division of Emergency Medicine, Department of Pediatrics, CHU Sainte-Justine, Montréal, Qc, Canada H3T 1C5 Department of Emergency Medicine, Hôpital du Sacré-Coeur, Université de Montréal, Montreal, Qc, Canada.
authors.forename: Benoit
authors.initials: B
authors.lastname: Bailey
authors.forename: Raoul
authors.initials: R
authors.lastname: Daoust
authors.forename: Evelyne
authors.initials: E
authors.lastname: Doyon-Trottier
authors.forename: Sabine
authors.initials: S
authors.lastname: Dauphin-Pierre
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Gravel
mesh_terms: D000208:Acute Disease / Q000523:psychology / Q000628:therapy; D000293:Adolescent; D000367:Age Factors; D000698:Analgesia / Q000379:methods; D000700:Analgesics / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods; D010147:Pain Measurement / Q000379:methods* / Q000592:standards; D010148:Intractable Pain / Q000145:classification* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012647:Self-Assessment
chemical_list: D000700:Analgesics