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Objective: Quantifying pain intensity is challenging, particularly for patients with chronic pain. The visual analog scale (VAS) is limited by ceiling effects that often leave patients with no ability to quantify worsening pain. The goal of this study was to determine whether the general Labeled Magnitude Scale (gLMS) can be feasibly used to measure pain clinically while overcoming limitations of the VAS. Design: Eighty patients (mean age, 53.7 yrs) scheduled for evaluation of a painful complaint were asked to rate their current pain using the gLMS and the VAS. The time necessary to administer the gLMS was recorded to determine feasibility. The difference in rating between the two scales (VAS and gLMS) was the main outcome measure. Results: After scaling and rounding off the gLMS scores for direct comparison, it was found that the gLMS scores were significantly lower than the corresponding VAS scores by a mean of 1.78 (P < 0.001). The mean time to administer the gLMS was 2.66 mins. Conclusions: These results suggest that the gLMS has great potential and can be feasibly used to measure pain intensity clinically. The gLMS scores were consistently lower than the VAS scores, thus reducing the ceiling effect and allowing range at the high end of the scale for rating worsening pain. [ABSTRACT FROM AUTHOR]

Objectives Glucocorticoids (GCs) ('steroids') are used to treat rheumatic diseases but adverse effects are common. We aimed to explore the impact of GC therapy on health-related quality of life (HRQoL), to inform the development of a treatment-specific patient-reported outcome measure (PROM) for use in clinical trials and practice. Methods Semi-structured qualitative interviews were conducted with patients from the UK, USA and Australia, treated for a rheumatic condition with GCs in the last 2 years. Purposive sampling was used to select participants with a range of demographic and disease features. An initial conceptual framework informed interview prompts and cues. Interviews elicited GC-related physical and psychological symptoms and salient aspects of HRQoL in relation to GC therapy. Interview data were analysed inductively to develop initial individual themes and domains. Candidate questionnaire items were developed and refined. Results Sixty semi-structured qualitative interviews were conducted (UK n  = 34, USA n  = 10, Australia n  = 16). The mean age was 58 years; 39/60 were female; and 18 rheumatic diseases were represented. Some 126 individual themes were identified and organized into six domains: physical symptoms; psychological symptoms; psychological impact of steroids; impact of steroids on participation; impact of steroids on relationships; and benefits of steroids. Candidate questionnaire items were tested and refined by piloting with patient research partners, iterative rounds of cognitive interviews and linguistic translatability assessment, informing a draft questionnaire. Conclusion We describe an international qualitative study to develop candidate items for a treatment-specific PROM for patients with rheumatic diseases. A future survey will enable the validation of a final version of the PROM. [ABSTRACT FROM AUTHOR]