Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Tuesday, 12 / 12 / 2017

Articles

Assessment of the Visual Analogue Score in the Evaluation of the Pruritus of Cholestasis

ORIGINAL ARTICLE

Assessment of the Visual Analogue Score in the Evaluation of the Pruritus of Cholestasis

Nora V. Bergasa*1,2 and E. Anthony Jones#,3

1NYC, H + H Metropolitan, New York, NY, USA
2New York Medical College, Valhalla, NY, USA
3Department of Gastroenterology and Liver Diseases, Academic Medical Center, Amsterdam, The Netherlands

*Correspondence to: Nora V. Bergasa, NYC, H + H, Metropolitan 1901 First Avenue, New York, NY 10128, USA. Tel: +1-212-423-6771, Fax: +1-212-423-8099, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2017;5(3):203-207 DOI: 10.14218/JCTH.2017.00001
Received: January 7, 2017 Accepted: May 23, 2017 Published online: July 7, 2017

Abstract

Background and Aims: A visual analogue score (VAS), based on application of a visual analogue scale, has been widely used to assess pruritus in clinical studies of patients with cholestatic liver disease. A VAS is a numerical score of the severity of the perception of pruritus, and, hence, is inherently subjective. The objective of this study was to assess the reliability of a VAS as an index of pruritus in cholestatic patients.

Methods: In 8 patients with chronic pruritus due to primary biliary cholangitis, values for a VAS of pruritus were compared with corresponding measurements of scratching activity, which were generated by a monitoring system specifically designed to quantitate this activity. The relationship between individual values for the VAS and corresponding values for scratching activity during a specific interval immediately preceding the recording of the VAS was examined by determining the Spearman’s rank correlation coefficient.

Results: The mean Spearman’s rank correlation coefficient between individual values for the VAS and corresponding mean values for scratching activity was 0.072; the range of these coefficients was −0.04 to 0.26. A VAS of pruritus is an unreliable index of scratching activity, and, hence, of the pathophysiological process responsible for the pruritus of cholestasis.

Conclusions: It is concluded that the use of a VAS as a primary quantitative endpoint in trials of the efficacy of potential therapies for the pruritus of cholestasis may be inappropriate.

Keywords

Pruritus, Cholestasis, Visual analogue score, Scratching activity, Primary biliary cholangitis, Quantitative efficacy endpoint

 

Journal of Clinical and Translational Hepatology 2017 vol. 5, 203-207  Html ] [ PDF Full-text ]

 

© The Authors 2017. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

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