Two patients were excluded because of a score entry error from the phone touch screen. Patients with a chief complaint of shoulder, elbow, hip, or knee pain were eligible for inclusion. Patients aged < younger than age < 18 years were excluded from the study. Patient consent was obtained by the same investigator in the clinic. One hundred consecutive orthopaedic sports medicine patients aged ≥18 years from the practices of two participating sports medicine fellowship-trained, American Board of Orthopaedic Surgery–certified orthopaedic surgeons were enrolled in the study between May 23, 2016, and June 28, 2016. We obtained institutional review board approval for this prospective randomized controlled trial. It was hypothesized that there would be no statistically significant differences in measurements obtained from the platforms, there would be no clinically relevant differences between the three platforms, and both digital VAS platforms would be in agreement with the traditional paper-based VAS assessment. The purpose of this study was to evaluate differences between the traditional paper-based VAS assessment and VAS scores obtained from each of two different digital VAS platforms (laptop computer and mobile phone) and to determine whether there are (1) statistically significant differences between the platforms (2) clinically relevant differences between the platforms and (3) instrument agreement between the platforms. However, paper and digital formats may not be equivalent in terms of reporting VAS scores mainly because of the size of the scale used on each platform. 12 A digital-based VAS platform could be easily integrated into the electronic medical record, obviating the need to scan individual paper VAS scores into the system for each patient and allowing for more rapid universal access to the results of such tests to improve patient care and pain management. The increasing use of electronic medical records makes switching from a paper-based format to a digital format for VAS testing more convenient for tracking and analyzing patient data. 4 Although there is conflicting evidence with regard to the advantage of the VAS compared with other methods for recording pain, 4 it is still commonly used in clinical and home settings. In addition to pain, the scale has also been used to evaluate mood, appetite, asthma, dyspepsia, and ambulation.
The values can be used to track pain progression for a patient or to compare pain between patients with similar conditions. 10 Measurements from the starting point (left end) of the scale to the patients' marks are recorded in centimeters and are interpreted as their pain.
2 Scores are based on self-reported measures of symptoms that are recorded with a single handwritten mark placed at one point along the length of a 10-cm line that represents a continuum between the two ends of the scale-“no pain” on the left end (0 cm) of the scale and the “worst pain” on the right end of the scale (10 cm). The visual analog scale (VAS) is a pain rating scale 1, 2, 3, 4, 5, 6, 7, 8, 9 first used by Hayes and Patterson in 1921.
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