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DOI: 10.1055/s-2008-1027685
© Georg Thieme Verlag KG Stuttgart · New York
Gütekriterien der visuellen Analogskala zur Schmerzbewertung
Quality Criteria of the Visual Analogue Scale for Pain AssessmentPublikationsverlauf
eingereicht: 25.9.2007
angenommen: 18.11.2007
Publikationsdatum:
15. August 2008 (online)

Zusammenfassung
Hintergrund: Die visuelle Analogskala (VAS) ist eines von verschiedenen Instrumenten zur Messung subjektiver Empfindungen wie der Schmerzintensität. Sie findet in der Physiotherapie zunehmend Verbreitung.
Ziel: Analyse der Gütekriterien Validität, Reliabilität (mit Objektivität) und Empfindlichkeit für klinisch relevante Veränderungen der VAS; Beschreibung des Skalenniveaus der VAS für die zu wählenden statistischen Tests.
Methode: Literatursuche in 3 Datenbanken und Referenzlisten.
Ergebnisse: Die VAS erscheint valide, reliabel sowie objektiv und erfasst mit hoher Sensitivität Änderungen der Schmerzempfindung. Die klinisch relevante Reduktion der VAS-Werte beginnt bei kleinen Eingangswerten schon ab 5 – 10 / 100 mm, während bei Eingangswerten von über 40 / 100 mm eine Mindestveränderung von 20 mm oder 30 % angegeben wird. Bei der Berechnung sind die Verbesserungen in Prozent denen in absoluten Zahlenwerten vorzuziehen. Die VAS-Werte besitzen die Eigenschaften einer Rationalskala und erlauben bei vorausgesetzter Normalverteilung die Anwendung parametrischer Tests zur statistischen Berechnung. Die Fehlerquote beim Ausfüllen der VAS ist mit 4 – 11 % gering. Da sie bei älteren und desorientierten Patienten höher liegt, bevorzugen diese häufig eine verbale Ratingskala.
Schlussfolgerung: Die VAS scheint die wissenschaftlichen Gütekriterien zu erfüllen und eignet sich zur Messung subjektiver Empfindungen wie der Schmerzäußerung in der Physiotherapie.
Abstract
Background: The visual analogue scale (VAS) is one of various instruments to measure subjective sensations like pain intensity. It is more and more used in physiotherapy.
Objective: Analysis of the quality criteria validity, reliability (with objectivity) and responsiveness to clinical relevant change of VAS; description of the VAS scale level for the correct selection of statistic tests.
Method: Literature search in 3 databases and reference lists.
Results: The VAS seems to be valid, reliable and objective, and is highly sensitive to detect changes in pain sensation. In the case of low baseline VAS scores the clinical relevant reduction in VAS values starts at 5 – 10 / 100 mm whereas with baseline VAS scores above 40 / 100 mm a minimal change of 20 mm or 30 % is indicated. In analysis improvements in percentage are preferred to absolute value quotations. The VAS scores hold the attributes of a ratio scale and assuming normal distribution allow the application of parametric tests for statistical analysis. With 4 – 11 % the error rate of VAS application is low. As the score is higher in elderly and disoriented patients, they often prefer a verbal rating scale.
Conclusion: The VAS seems to meet the scientific quality criteria and is suitable for measurements of subjective sensations like pain manifestation in physiotherapy.
Schlüsselwörter
visuelle Analogskala - numerische Ratingskala - verbale Ratingskala - Validität - Reliabilität - Empfindlichkeit für Veränderungen - Statistik
Key words
visual analogue scale - numeric rating scale - verbal rating scale - validity - reliability - responsiveness to change - statistics
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Jochen Schomacher
PT, PT-OMT, MCMK (F), DPT (USA), B. Sc. Phys., M. Sc. Phys. (D)
Dorfstr. 24
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eMail: Jochen-Schomacher@web.de