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American Journal of Physical Medicine & Rehabilitation:
doi: 10.1097/PHM.0b013e31829e76f7
Case Report

Moving Beyond the Limitations of the Visual Analog Scale for Measuring Pain: Novel Use of the General Labeled Magnitude Scale in a Clinical Setting

González-Fernández, Marlís MD, PhD; Ghosh, Nilasha BA; Ellison, Tambrea MD; McLeod, Julia C. MBBS (Hons I); Pelletier, Cathy A. PhD; Williams, Kayode MD, MBA

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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.

Design

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.

Copyright © 2013 by Lippincott Williams & Wilkins

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