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Publication
Validity of four pain intensity rating scales
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Advisor(s)
Abstract(s)
The Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), and the Faces
Pain Scale-Revised (FPS-R) are among the most commonly used measures of pain intensity in clinical and
research settings. Although evidence supports their validity as measures of pain intensity, few studies
have compared them with respect to the critical validity criteria of responsivity, and no experiment
has directly compared all 4 measures in the same study. The current study compared the relative validity
of VAS, NRS, VRS, and FPS-R for detecting differences in painful stimulus intensity and differences
between men and women in response to experimentally induced pain. One hundred twenty-seven subjects
underwent four 20-second cold pressor trials with temperature order counterbalanced across 1 C,
3 C, 5 C, and 7 C and rated pain intensity using all 4 scales. Results showed statistically significant differences
in pain intensity between temperatures for each scale, with lower temperatures resulting in
higher pain intensity. The order of responsivity was as follows: NRS, VAS, VRS, and FPS-R. However, there
were relatively small differences in the responsivity between scales. A statistically significant sex main
effect was also found for the NRS, VRS, and FPS-R. The findings are consistent with previous studies supporting
the validity of each scale. The most support emerged for the NRS as being both (1) most responsive
and (2) able to detect sex differences in pain intensity. The results also provide support for the
validity of the scales for use in Portuguese samples.
Description
Keywords
Pain assessment Validity Numerical rating scale Visual analogue scale Faces pain scale Verbal rating scale
Citation
PAIN, 152, 2399-2404