This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Le Resche, L. Articles by Dworkin, S.F. Search for Related Content PubMed PubMed Citation Articles by Le Resche, L. Articles by Dworkin, S.F. Social Bookmarking                         What's this?

Reliability of Visual Analog and Verbal Descriptor Scales for "Objective" Measurement of Temporomandibular Disorder Pain

Department of Oral Medicine SC-63, University of Washington, Seattle, Washington 98195

J. Burgess

Department of Oral Medicine SC-63, University of Washington, Seattle, Washington 98195, Pain Center, University Hospital RC-76, University of Washington, Seattle, Washington 98195

S.F. Dworkin

Department of Oral Medicine SC-63, University of Washington, Seattle, Washington 98195, Department of Psychiatry and Behavioral Sciences RP-10, University of Washington, Seattle, Washington 98195

Eight dentists viewed standardized videotapes showing palpations of the temporomandibular joint and muscles of mastication and recorded their judgments concerning the amount of pain the patient was experiencing. Judgments were recorded using a four-point verbal descriptor scale (VDS) ("none", "mild", "moderate", "severe "pain) or a 100-mm visual analog scale (VAS) anchored with the terms "no pain" and "worst pain possible". Test/re-test reliability over a one-week period and interjudge reliabilities were calculated for each scale; reliabilities of the two scales were directly compared based on the statistical equivalence of weighted kappa and the Intraclass Correlation Coefficient.

Neither scale showed satisfactory reliability. Median test/re-test reliabilities were k = 0.590 for the VDS and r = 0.822 for the VAS. Interjudge reliabilities averaged k = 0.394 for the VDS and r = 0. 735 for the VAS. Direct comparison of reliabilities for the two scales showed no clear advantage for either scale. The marginal reliabilities of these scales, when used by dentists to quantify the patient's pain, suggest that neither scale should be regarded as an "objective" pain measure.

REFERENCES

• American Dental Association (1983): Report of the President's Conference on the Examination, Diagnosis and Management of Temporomandibular Disorders, J Am Dent Assoc 66:75-77.
• Anastasi, A. (1961):Psychological Testing. 2nd ed., New York: Macmillan.
• Cohen, J. (1960): A Coefficient of Agreement for Nominal Scales, Educ and Psychol Measurement 20: 37-46.
• Cohen, J. (1968): Weighted Kappa: Nominal Scale Agreement with Provision for Scaled Disagreement or Partial Credit, Psychol Bull 70: 213-220.[CrossRef][Medline] [Order article via Infotrieve]
• Dworkin, S.F.; Von Korff, M.; Truelove, E.; Sommers, E.; and Le Resche, L. (1986): Reliability of Examiners Assessing TMD Signs and Symptoms, J Dent Res 65 (Sp IssB): 820, Abst. No. 853 (IADR).
• Fleiss, J. (1981): Statistical Methods for Rates and Proportions, 2nd ed., New York: Wiley.
• Fleiss, J. and Cohen, J. (1973): The Equivalence of Weighted Kappa and the Intraclass Correlation Coefficient as Measures of Reliability, Educ and Psychol Measurement 33: 613-619.
• Fricton, J. and Schiffman, E. (1986): A Pressure Algometer for Muscle Palpation: Reliability and Validity, J Dent Res 65 (Sp IssA): 334, Abst. No. 1490 (AADR).
• Gross, A. and Gale, E.N. (1983): A Prevalence Study of the Clinical Signs and Symptoms Associated with Mandibular Dysfunction, JAm Dent Assoc 107: 932-936.
• Heft, M. and Parker, S.R. (1986): Visual Analog Scales (VAS) of Pain: Ratio or Interval Scales?, J Dent Res 65 (Sp IssA): 307, Abst. No. 1241 (AADR).
• Huskisson, E.C. (1983): Visual Analog Scales. In: Pain Measurement and Assessment, R. Melzack, Ed., New York: Raven Press, pp. 33-37.
• International Association for the Study of Pain, Subcommittee on Taxonomy (1979): Pain Terms: A List with Definitions and Notes on Usage, Pain 6: 249-252.[Medline] [Order article via Infotrieve]
• Kleinknecht, R.; Dworkin, S.F.; Truelove, E.L.; Le Resche, L.; and Sommers, E. (1984): Chronic TMJ/MPD Pain: Subjective Signs and Clinical Findings, J Dent Res 63 (Sp IssA): 297, Abst. No. 1139.
• Kleinknecht, R.A.; Mahoney, E.R.; Alexander, L.D.; and Dworkin, S.F. (1986): Correspondence Between Subjective Report of Temporomandibular Disorder Symptoms and Clinical Findings, J Am Dent Assoc 113: 257-261.[Medline] [Order article via Infotrieve]
• Kopp, S. and Wenneberg, B. (1983): Intra- and Interobserver Variability in the Assessment of Signs of Disorder in the Stomatognathic System, Swed Dent J 7: 239-246.[Medline] [Order article via Infotrieve]
• Koran, L. (1975a): The Reliability of Clinical Methods, Data and Judgments (first of two parts), New Engl J Med 293: 642-646.[Medline] [Order article via Infotrieve]
• Koran, L. (1975b): The Reliability of Clinical Methods, Data and Judgments (second of two parts), New Engl J Med 293:695-701.[Medline] [Order article via Infotrieve]
• Landis, J.R. and Koch, G.G. (1977): An Application of Hierarchical Kappa-type Statistics in the Assessment of Majority Agreement Among Multiple Observers, Biometrics 33:363-374.[CrossRef][Medline] [Order article via Infotrieve]
• Larsson, E. and Ronnerman, A. (1981): Mandibular Dysfunction Symptoms in Orthodontically Treated Patients Ten Years After the Completion of Treatment, Eur J Orthodontics 3:89-94.
• Mejersjo, C. and Carlsson, G. (1983): Long-term Results of Treatment for Temporomandibular Joint Pain-Dysfunction, J Prosthet Dent 49:809-815.[CrossRef][Medline] [Order article via Infotrieve]
• Mejias, J. and Mehta, N. (1982): Subjective and Objective Evaluation of Bruxing Patients Undergoing Short-term Splint Therapy, J Oral Rehabil 9:279-289.[Medline] [Order article via Infotrieve]
• Okeson, J.; Moody, P.; Kemper, J.; and Haley, J. (1983): Evaluation of Occlusal Splint Therapy and Relaxation Procedures in Patients with Temporomandibular Disorders, J Am Dent Assoc 107:42(M24.[Abstract]
• Reeves, J.L.; Jaeger, B.; and Graff-Radford, S.B. (1986): Reliability of the Pressure Algometer as a Measure of Myofascial Trigger Point Sensitivity, Pain 24:313-321.[CrossRef][Medline] [Order article via Infotrieve]
• Shrout, P.E. and Fleiss, J.L. (1979): Intraclass Correlations: Uses in Assessing Rater Reliability, Psychol Bull 86:420-428.[CrossRef][Medline] [Order article via Infotrieve]
• Solberg, W.K.; Woo, M.W.; and Houston, J.B. (1979): Prevalence of Mandibular Dysfunction in Young Adults, J Am Dent Assoc 98:25-34.[Abstract]
• Stolov, W. (1982): Evaluation of the Patient. In: Krausen's Handbook of Physical Medicine and Rehabilitation, F.J. Kottke, G.K. Stillwell, and J.F. Lehmann, Eds., Philadelphia: W.B. Saunders, pp. 1-18.
• Travell, J.G. (1976): Myofascial Trigger Points: Clinical View. In: Advances in Pain Research and Therapy, Volume I, J.J. Bonica and D. Albe-Fessard, Eds., New York: Raven Press, pp. 919-926.

Journal of Dental Research, Vol. 67, No. 1, 33-36 (1988)
DOI: 10.1177/00220345880670010601


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				K. K Mangione and K. M Palombaro Exercise Prescription for a Patient 3 Months After Hip Fracture Physical Therapy, July 1, 2005; 85(7): 676 - 687. [Abstract] [Full Text] [PDF]

				M. Averbuch and M. Katzper Assessment of Visual Analog versus Categorical Scale for Measurement of Osteoarthritis Pain J. Clin. Pharmacol., April 1, 2004; 44(4): 368 - 372. [Abstract] [Full Text] [PDF]

				R. Ohrbach, J. Blascovich, E.N. Gale, W.D. McCall Jr, and S.F. Dworkin Psychophysiological Assessment of Stress in Chronic Pain: Comparisons of Stressful Stimuli and of Response Systems Journal of Dental Research, October 1, 1998; 77(10): 1840 - 1850. [Abstract] [PDF]

This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Le Resche, L. Articles by Dworkin, S.F. Search for Related Content PubMed PubMed Citation Articles by Le Resche, L. Articles by Dworkin, S.F. Social Bookmarking                         What's this?