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Research ArticleAccepted Article

Comparing the visual analogue scale (VAS) and the numerical rating scale (NRS) in patient reported outcomes in psoriatic arthritis

Weiyu Ye, Simon Hackett, Claire Vandevelde, Sarah Twigg, Philip S. Helliwell and Laura C. Coates
The Journal of Rheumatology December 2020, jrheum.200928; DOI: https://doi.org/10.3899/jrheum.200928
Weiyu Ye
Oxford University Clinical Academic Graduate School, Room 3A31, The Cairns Library IT Corridor, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU;ford, The Botnar Research Centre, Old Road, Oxford, OX3 7LD; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, LS7 4SA; Bradford Teaching Hospitals NHS Foundation Trust, St Lukes Hospital, Little Horton Lane, Bradford, BD5 0NA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA. Funding: Weiyu Ye is an NIHR Academic Clinical Fellow. Laura C Coates is an NIHR Clinician Scientist and Senior Clinical Research Fellow funded by a National Institute for Health Research Clinician Scientist award. The research was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We acknowledge the support of the National Institute for Health Research Clinical Research Network (NIHR CRN). Address correspondence to Dr Weiyu Ye, Oxford University Clinical Academic Graduate School, Room 3A31, The Cairns Library IT Corridor, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU. Email: christina.ye@conted.ox.ac.uk
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Simon Hackett
Oxford University Clinical Academic Graduate School, Room 3A31, The Cairns Library IT Corridor, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU;ford, The Botnar Research Centre, Old Road, Oxford, OX3 7LD; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, LS7 4SA; Bradford Teaching Hospitals NHS Foundation Trust, St Lukes Hospital, Little Horton Lane, Bradford, BD5 0NA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA. Funding: Weiyu Ye is an NIHR Academic Clinical Fellow. Laura C Coates is an NIHR Clinician Scientist and Senior Clinical Research Fellow funded by a National Institute for Health Research Clinician Scientist award. The research was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We acknowledge the support of the National Institute for Health Research Clinical Research Network (NIHR CRN). Address correspondence to Dr Weiyu Ye, Oxford University Clinical Academic Graduate School, Room 3A31, The Cairns Library IT Corridor, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU. Email: christina.ye@conted.ox.ac.uk
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Claire Vandevelde
Oxford University Clinical Academic Graduate School, Room 3A31, The Cairns Library IT Corridor, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU;ford, The Botnar Research Centre, Old Road, Oxford, OX3 7LD; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, LS7 4SA; Bradford Teaching Hospitals NHS Foundation Trust, St Lukes Hospital, Little Horton Lane, Bradford, BD5 0NA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA. Funding: Weiyu Ye is an NIHR Academic Clinical Fellow. Laura C Coates is an NIHR Clinician Scientist and Senior Clinical Research Fellow funded by a National Institute for Health Research Clinician Scientist award. The research was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We acknowledge the support of the National Institute for Health Research Clinical Research Network (NIHR CRN). Address correspondence to Dr Weiyu Ye, Oxford University Clinical Academic Graduate School, Room 3A31, The Cairns Library IT Corridor, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU. Email: christina.ye@conted.ox.ac.uk
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Sarah Twigg
Oxford University Clinical Academic Graduate School, Room 3A31, The Cairns Library IT Corridor, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU;ford, The Botnar Research Centre, Old Road, Oxford, OX3 7LD; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, LS7 4SA; Bradford Teaching Hospitals NHS Foundation Trust, St Lukes Hospital, Little Horton Lane, Bradford, BD5 0NA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA. Funding: Weiyu Ye is an NIHR Academic Clinical Fellow. Laura C Coates is an NIHR Clinician Scientist and Senior Clinical Research Fellow funded by a National Institute for Health Research Clinician Scientist award. The research was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We acknowledge the support of the National Institute for Health Research Clinical Research Network (NIHR CRN). Address correspondence to Dr Weiyu Ye, Oxford University Clinical Academic Graduate School, Room 3A31, The Cairns Library IT Corridor, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU. Email: christina.ye@conted.ox.ac.uk
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Philip S. Helliwell
Oxford University Clinical Academic Graduate School, Room 3A31, The Cairns Library IT Corridor, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU;ford, The Botnar Research Centre, Old Road, Oxford, OX3 7LD; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, LS7 4SA; Bradford Teaching Hospitals NHS Foundation Trust, St Lukes Hospital, Little Horton Lane, Bradford, BD5 0NA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA. Funding: Weiyu Ye is an NIHR Academic Clinical Fellow. Laura C Coates is an NIHR Clinician Scientist and Senior Clinical Research Fellow funded by a National Institute for Health Research Clinician Scientist award. The research was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We acknowledge the support of the National Institute for Health Research Clinical Research Network (NIHR CRN). Address correspondence to Dr Weiyu Ye, Oxford University Clinical Academic Graduate School, Room 3A31, The Cairns Library IT Corridor, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU. Email: christina.ye@conted.ox.ac.uk
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Laura C. Coates
Oxford University Clinical Academic Graduate School, Room 3A31, The Cairns Library IT Corridor, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU;ford, The Botnar Research Centre, Old Road, Oxford, OX3 7LD; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, LS7 4SA; Bradford Teaching Hospitals NHS Foundation Trust, St Lukes Hospital, Little Horton Lane, Bradford, BD5 0NA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA. Funding: Weiyu Ye is an NIHR Academic Clinical Fellow. Laura C Coates is an NIHR Clinician Scientist and Senior Clinical Research Fellow funded by a National Institute for Health Research Clinician Scientist award. The research was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We acknowledge the support of the National Institute for Health Research Clinical Research Network (NIHR CRN). Address correspondence to Dr Weiyu Ye, Oxford University Clinical Academic Graduate School, Room 3A31, The Cairns Library IT Corridor, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU. Email: christina.ye@conted.ox.ac.uk
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Abstract

Objective Patient self-report scales are invaluable in psoriatic arthritis (PsA), as they allow physicians to rapidly assess patient perspectives of disease activity. We aimed to assess the agreement of the visual analogue scale (VAS), a 100 mm horizontal line, and the numerical rating scale (NRS), a 21-point scale ranging from 0 to 10 in increments of 0.5, in patients with PsA.

Methods Data were collected prospectively across three UK hospital trusts from 2018-2019. All patients completed the VAS and NRS for pain, arthritis, skin psoriasis, and global disease activity. A subset completed an identical pack one week later. Demographic and clinical data were also collected. Agreement was assessed using medians and the Bland-Altman method. Intraclass correlation coefficients (ICC) were used to assess test-retest reliability. Spearman’s rank correlation coefficients were used to assess dependency between scale scores and clinical parameters.

Results 210 patients completed the study; one withdrew consent, thus 209 were analysed. For pain, arthritis, skin psoriasis and global disease activity, the difference between the VAS and NRS mostly lay within 1.96 SD of the mean, suggesting reasonable agreement between the two scales. 64.1% patients preferred the NRS. The ICCs demonstrate excellent test-retest reliability for both VAS and NRS. Higher VAS and NRS scores were associated with increased tender/swollen joint count, poorer functional status and greater life impact.

Conclusion The VAS and NRS show reasonable agreement in key patient reported outcomes in PsA. Results from both scales are correlated with disease severity and life impact.

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Accepted manuscript
Comparing the visual analogue scale (VAS) and the numerical rating scale (NRS) in patient reported outcomes in psoriatic arthritis
Weiyu Ye, Simon Hackett, Claire Vandevelde, Sarah Twigg, Philip S. Helliwell, Laura C. Coates
The Journal of Rheumatology Dec 2020, jrheum.200928; DOI: 10.3899/jrheum.200928

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Accepted manuscript
Comparing the visual analogue scale (VAS) and the numerical rating scale (NRS) in patient reported outcomes in psoriatic arthritis
Weiyu Ye, Simon Hackett, Claire Vandevelde, Sarah Twigg, Philip S. Helliwell, Laura C. Coates
The Journal of Rheumatology Dec 2020, jrheum.200928; DOI: 10.3899/jrheum.200928
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