Lily Y L Chiu1, Terri Sun2, Ronald Ree2,3, Dustin Dunsmuir2,4, Alexander Dotto2,5, J Mark Ansermino2,4,6, Cynthia Yarnold2,3. 1. Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada. lilyqiu@alumni.ubc.ca. 2. Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada. 3. Department of Anesthesia, Providence Health Care, St. Paul's Hospital, Vancouver, BC, Canada. 4. BC Children's Hospital Research Institute, Vancouver, BC, Canada. 5. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. 6. Department of Pediatric Anesthesia, BC Children's Hospital, Vancouver, BC, Canada.
Abstract
PURPOSE: The Pain assessment using a novel digital application (Panda) is a smartphone application that contains the digital versions of the visual analogue scale (VAS-100) and numeric rating scale (NRS-11). This study aimed to investigate if the Panda versions of these two pain scales are equivalent to the paper versions in adult patients. METHODS: This was a prospective, randomized, cross-over-controlled trial of subjects aged 19-75 yr undergoing procedures with anticipated post-surgical pain. Each subject used both the Panda and paper versions of VAS-100 or NRS-11 pain scores after emergence from anesthesia and after meeting postanesthesia care unit (PACU) discharge criteria. Correlations between the two tools were analyzed, and Bland-Altman agreement was calculated. The smartphone and paper versions were considered equivalent at each time point if the differences (and their 95% confidence interval [CI]) between them were less than 20 points for the VAS-100 and 2.1 for NRS-11. RESULTS: The two versions of the VAS-100 correlated strongly after emergence (Pearson's r = 0.93; P < 0.001) and upon meeting discharge criteria (r = 0.94; P < 0.001); the mean (standard deviation [SD]) Panda score after emergence was 35 (27) compared with the paper score of 37 (26) (mean difference, - 2; 95% CI, - 22 to 19). The mean (SD) VAS-100 Panda score upon meeting discharge criteria was 21 (20) compared with the paper score of 23 (21) (mean difference, - 2; 95% CI, - 17 to 13). For the NRS-11, Panda again correlated strongly with the original tool scores after emergence (r = 0.93; P < 0.001) and upon meeting discharge criteria (r = 0.96; P < 0.001); the mean (SD) Panda and paper scores after emergence were both 4 (3) (mean difference, 0.05; 95% CI, - 1.87 to 1.96). The mean (SD) NRS-11 Panda and paper scores upon meeting PACU discharge criteria were both 3 (2) (mean difference, - 0.08; 95% CI, - 1.41 to 1.26). CONCLUSION: Following emergence from anesthesia in adult patients, the digital Panda version of the NRS-11, but not the VAS-100, is equivalent to the validated paper version. In those who are ready for discharge from the PACU, the digital Panda versions of both the VAS-100 and NRS-11 agreed adequately and can be used in place of the original paper versions.
RCT Entities:
PURPOSE: The Pain assessment using a novel digital application (Panda) is a smartphone application that contains the digital versions of the visual analogue scale (VAS-100) and numeric rating scale (NRS-11). This study aimed to investigate if the Panda versions of these two pain scales are equivalent to the paper versions in adult patients. METHODS: This was a prospective, randomized, cross-over-controlled trial of subjects aged 19-75 yr undergoing procedures with anticipated post-surgical pain. Each subject used both the Panda and paper versions of VAS-100 or NRS-11 pain scores after emergence from anesthesia and after meeting postanesthesia care unit (PACU) discharge criteria. Correlations between the two tools were analyzed, and Bland-Altman agreement was calculated. The smartphone and paper versions were considered equivalent at each time point if the differences (and their 95% confidence interval [CI]) between them were less than 20 points for the VAS-100 and 2.1 for NRS-11. RESULTS: The two versions of the VAS-100 correlated strongly after emergence (Pearson's r = 0.93; P < 0.001) and upon meeting discharge criteria (r = 0.94; P < 0.001); the mean (standard deviation [SD]) Panda score after emergence was 35 (27) compared with the paper score of 37 (26) (mean difference, - 2; 95% CI, - 22 to 19). The mean (SD) VAS-100 Panda score upon meeting discharge criteria was 21 (20) compared with the paper score of 23 (21) (mean difference, - 2; 95% CI, - 17 to 13). For the NRS-11, Panda again correlated strongly with the original tool scores after emergence (r = 0.93; P < 0.001) and upon meeting discharge criteria (r = 0.96; P < 0.001); the mean (SD) Panda and paper scores after emergence were both 4 (3) (mean difference, 0.05; 95% CI, - 1.87 to 1.96). The mean (SD) NRS-11 Panda and paper scores upon meeting PACU discharge criteria were both 3 (2) (mean difference, - 0.08; 95% CI, - 1.41 to 1.26). CONCLUSION: Following emergence from anesthesia in adult patients, the digital Panda version of the NRS-11, but not the VAS-100, is equivalent to the validated paper version. In those who are ready for discharge from the PACU, the digital Panda versions of both the VAS-100 and NRS-11 agreed adequately and can be used in place of the original paper versions.
Authors: Alexander Dotto; Dustin Dunsmuir; Terri Sun; Lily Y L Chiu; Ronald Ree; J Mark Ansermino; Cynthia H Yarnold Journal: Can J Anaesth Date: 2020-06-04 Impact factor: 5.063
Authors: Lindsay A Jibb; James S Khan; Puneet Seth; Chitra Lalloo; Lauren Mulrooney; Kathryn Nicholson; Dominik A Nowak; Harneel Kaur; Alyssandra Chee-A-Tow; Joel Foster; Jennifer N Stinson Journal: J Med Internet Res Date: 2020-06-16 Impact factor: 5.428