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The use of visual analogue scales to assess motivation to eat in human subjects: a review of their reliability and validity with an evaluation of new hand-held computerized systems for temporal tracking of appetite ratings

Published online by Cambridge University Press:  09 March 2007

R. J. Stubbs ,
D. A. Hughes ,
A. M. Johnstone ,
E. Rowley ,
C. Reid ,
M. Elia ,
R. Stratton ,
H. Delargy ,
N. King  and
J. E. Blundell
R. J. Stubbs*
Affiliation:
Rowett Research Institute, Greenburn Road, Bucksburn, Aberdeen, AB21 9SB, UK
D. A. Hughes
Affiliation:
Rowett Research Institute, Greenburn Road, Bucksburn, Aberdeen, AB21 9SB, UK
A. M. Johnstone
Affiliation:
Rowett Research Institute, Greenburn Road, Bucksburn, Aberdeen, AB21 9SB, UK
E. Rowley
Affiliation:
Rowett Research Institute, Greenburn Road, Bucksburn, Aberdeen, AB21 9SB, UK
C. Reid
Affiliation:
Biomathematics and Statistics, Scotland, Rowett Research Institute, Greenburn Road, Bucksburn, Aberdeen, AB21 9SB, UK
M. Elia
Affiliation:
Clinical Nutrition Group, The Dunn Clinical Nutrition Centre, Hills Road, Cambridge, UK
R. Stratton
Affiliation:
Clinical Nutrition Group, The Dunn Clinical Nutrition Centre, Hills Road, Cambridge, UK
H. Delargy
Affiliation:
Biopsychology Group, Psychology Department, University of Leeds, Leeds LS2 9JT, UK
N. King
Affiliation:
Biopsychology Group, Psychology Department, University of Leeds, Leeds LS2 9JT, UK
J. E. Blundell
Affiliation:
Biopsychology Group, Psychology Department, University of Leeds, Leeds LS2 9JT, UK
*
*Corresponding author: Dr R. James Stubbs, fax +44 (0) 1224 715349, email J.Stubbs@rri.sari.ac.uk
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Abstract

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This present paper reviews the reliability and validity of visual analogue scales (VAS) in terms of (1) their ability to predict feeding behaviour, (2) their sensitivity to experimental manipulations, and (3) their reproducibility. VAS correlate with, but do not reliably predict, energy intake to the extent that they could be used as a proxy of energy intake. They do predict meal initiation in subjects eating their normal diets in their normal environment. Under laboratory conditions, subjectively rated motivation to eat using VAS is sensitive to experimental manipulations and has been found to be reproducible in relation to those experimental regimens. Other work has found them not to be reproducible in relation to repeated protocols. On balance, it would appear, in as much as it is possible to quantify, that VAS exhibit a good degree of within-subject reliability and validity in that they predict with reasonable certainty, meal initiation and amount eaten, and are sensitive to experimental manipulations. This reliability and validity appears more pronounced under the controlled (but more artificial) conditions of the laboratory where the signal: noise ratio in experiments appears to be elevated relative to real life. It appears that VAS are best used in within-subject, repeated-measures designs where the effect of different treatments can be compared under similar circumstances. They are best used in conjunction with other measures (e.g. feeding behaviour, changes in plasma metabolites) rather than as proxies for these variables. New hand-held electronic appetite rating systems (EARS) have been developed to increase reliability of data capture and decrease investigator workload. Recent studies have compared these with traditional pen and paper (P&P) VAS. The EARS have been found to be sensitive to experimental manipulations and reproducible relative to P&P. However, subjects appear to exhibit a significantly more constrained use of the scale when using the EARS relative to the P&P. For this reason it is recommended that the two techniques are not used interchangeably.

Keywords

Visual analogue scalesElectronic appetite rating systemsAppetiteHunger
Type
Review article
Information
British Journal of Nutrition , Volume 84 , Issue 4 , October 2000 , pp. 405 - 415
Copyright
Copyright © The Nutrition Society 2000

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