Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain

TLDR

The study aimed to assess the reliability and concurrent validity of a single‑item visual analogue scale for disability in chronic musculoskeletal pain patients. The authors employed a test‑retest design for reliability and a cross‑sectional design for validity, enrolling 52 adults for reliability and 344 for validity at two rehabilitation centres, and measured Spearman correlations between the VAS disability scores and established disability and pain measures. Reliability was moderate to good (rho 0.60–0.77), but validity was weak with other disability instruments (rho 0.16–0.51) and strong only with pain scores (rho 0.76–0.84), rendering the VAS for disability’s validity questionable.

Abstract

To determine the reliability and concurrent validity of a visual analogue scale (VAS) for disability as a single-item instrument measuring disability in chronic pain patients was the objective of the study. For the reliability study a test-retest design and for the validity study a cross-sectional design was used. A general rehabilitation centre and a university rehabilitation centre was the setting for the study. The study population consisted of patients over 18 years of age, suffering from chronic musculoskeletal pain; 52 patients in the reliability study, 344 patients in the validity study. Main outcome measures were as follows. Reliability study: Spearman's correlation coefficients (rho values) of the test and retest data of the VAS for disability; validity study: rho values of the VAS disability scores with the scores on four domains of the Short-Form Health Survey (SF-36) and VAS pain scores, and with Roland-Morris Disability Questionnaire scores in chronic low back pain patients. Results were as follows: in the reliability study rho values varied from 0.60 to 0.77; and in the validity study rho values of VAS disability scores with SF-36 domain scores varied from 0.16 to 0.51, with Roland-Morris Disability Questionnaire scores from 0.38 to 0.43 and with VAS pain scores from 0.76 to 0.84. The conclusion of the study was that the reliability of the VAS for disability is moderate to good. Because of a weak correlation with other disability instruments and a strong correlation with the VAS for pain, however, its validity is questionable.