title: Moving beyond the limitations of the visual analog scale for measuring pain: novel use of the general labeled magnitude scale in a clinical setting.
abstract: OBJECTIVE
  Quantifying pain intensity is challenging, particularly for patients with chronic pain. The visual analog scale (VAS) is limited by ceiling effects that often leave patients with no ability to quantify worsening pain. The goal of this study was to determine whether the general Labeled Magnitude Scale (gLMS) can be feasibly used to measure pain clinically while overcoming limitations of the VAS.
  
  
  METHODS
  Eighty patients (mean age, 53.7 yrs) scheduled for evaluation of a painful complaint were asked to rate their current pain using the gLMS and the VAS. The time necessary to administer the gLMS was recorded to determine feasibility. The difference in rating between the two scales (VAS and gLMS) was the main outcome measure.
  
  
  RESULTS
  After scaling and rounding off the gLMS scores for direct comparison, it was found that the gLMS scores were significantly lower than the corresponding VAS scores by a mean of 1.78 (P < 0.001). The mean time to administer the gLMS was 2.66 mins.
  
  
  CONCLUSIONS
  These results suggest that the gLMS has great potential and can be feasibly used to measure pain intensity clinically. The gLMS scores were consistently lower than the VAS scores, thus reducing the ceiling effect and allowing range at the high end of the scale for rating worsening pain.
authors.affiliation: From the Department of Physical Medicine and Rehabilitation (MG-F, TE) and Department of Anesthesiology and Critical Care Medicine (KW), Johns Hopkins University School of Medicine, Baltimore, Maryland; School of Medicine, University of California, Irvine (NG); Department of Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Brisbane, Australia (JCM); and Charlestown Retirement Community, Catonsville, Maryland (CAP).
authors.forename: Marlís
authors.initials: M
authors.lastname: González-Fernández
authors.forename: Nilasha
authors.initials: N
authors.lastname: Ghosh
authors.forename: Tambrea
authors.initials: T
authors.lastname: Ellison
authors.forename: Julia C
authors.initials: JC
authors.lastname: McLeod
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Pelletier
authors.forename: Kayode
authors.initials: K
authors.lastname: Williams
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D059350:Chronic Pain / Q000175:diagnosis* / Q000628:therapy; D015331:Cohort Studies; D059026:Diagnostic Self Evaluation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018710:Pain Clinics; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement / Q000295:instrumentation / Q000379:methods*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D064232:Visual Analog Scale