Correspondence of verbal descriptor and numeric rating scales for pain intensity: an item response theory calibration
Abstract
BACKGROUND: Assessing pain intensity in older adults is critical and challenging. There is debate about the most effective way to ask older adults to describe their pain severity, and clinicians vary in their preferred approaches, making comparison of pain intensity scores across settings difficult. METHODS: A total of 3,676 residents from 71 community nursing homes across eight states were asked about pain presence. The 1,960 residents who reported pain within the past 5 days (53% of total, 70% female; age: M = 77.9, SD = 12.4) were included in analyses. Those who reported pain were also asked to provide a rating of pain intensity using either a verbal descriptor scale (VDS; mild, moderate, severe, and very severe and horrible), a numeric rating scale (NRS; 0 = no pain to 10 = worst pain imaginable), or both. We used item response theory (IRT) methods to identify the correspondence between the VDS and the NRS response options by estimating item parameters for these and five additional pain items. RESULTS: The sample reported moderate amounts of pain on average. Examination of the IRT location parameters for the pain intensity items indicated the following approximate correspondence: VDS mild approximately NRS 1-4, VDS moderate approximately NRS 5-7, VDS severe approximately NRS 8-9, and VDS very severe, horrible approximately NRS 10. CONCLUSION: This IRT calibration provides a crosswalk between the two response scales so that either can be used in practice depending on the preference of the clinician and respondent.
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The items used for impact stratification (pain intensity, pain interference, and functional status) have substantial research support for their discriminatory and prognostic importance.
“These items have substantial research support to validate their discriminatory and prognostic importance. 13, 19, 31, 38, 39, 43, 47–49, 53, 54, 57–60, 66–68, 73, 76, 80, 82, 85, 86, 97, 106, 108, 110, 112–116, 122”
From Report of the NIH Task Force on research standards for chronic low back pain. (2014) · cites this paper as [43]
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- Authors
- Edelen, M. O., & Saliba, D.
- Affiliations
- RAND Corporation (US)
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-01-27
- Volume
- 65A
- Issue
- 7
- Pages
- 778-785
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- OpenAlex
- W2097763833
- Cited by
- 68
- References
- 46
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 4 · 2020: 6 · 2019: 6 · 2018: 6 · 2017: 2 · 2016: 6 · 2015: 10 · 2014: 8 · 2013: 2 · 2012: 3
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Centers for Medicare and Medicaid Services
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- pain intensity, Verbal Descriptor Scale, numerical rating scale, older adults, nursing home residents, pain assessment
- MeSH terms
- Aged, Calibration, Female, Homes for the Aged, Humans, Male, Nursing Homes, Pain, Pain Measurement, Reference Values
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