Mixed-Method Exploration of Visual Analogue Scale (VAS) Variations to Measure Health, Social Care, and Carer-Related Quality of Life (QoL)
Author(s)
Jonathan L. Nazari, PharmD1, Maja Kuharic, PhD2, Justin Yu, PharmD1, A Simon Pickard, PhD1.
1Pharmacy Systems, Outcomes, and Policy, University of Illinois Chicago, Chicago, IL, USA, 2Northwestern University Feinberg School of Medicine, CHICAGO, IL, USA.
1Pharmacy Systems, Outcomes, and Policy, University of Illinois Chicago, Chicago, IL, USA, 2Northwestern University Feinberg School of Medicine, CHICAGO, IL, USA.
OBJECTIVES: Visual analog scales (VAS) can serve as brief yet informative patient reported outcome measures. This mixed methods study aimed to assess perceptions of a VAS with variations in the construct and recall period for measuring health, social care, and carer related QoL.
METHODS: US adults who were: 1) diagnosed with chronic illness; 2) unpaid caregivers; 3) social care users (e.g., received caregiving, living with disability) were recruited from ResearchMatch. In an online survey, three VAS variations were presented in a random order. Variations included no recall period with different constructs (‘quality of life’, ‘health’, and ‘health and well-being’) on a 0-100 scale. In an interview, participants discussed construct interpretation, appropriateness of recall periods (none, today, past 7 days), and whether these influenced their responses. Interviews were analyzed qualitatively through thematic analysis.
RESULTS: Thirty-four participants completed the survey and interview. Mean responses for QoL, health, and health and well-being (HWB) were 66.4 (SD=21.5), 61.9 (SD=21.3), and 60.9 (SD=21.8), respectively. Compared to health, effect sizes for QoL and HWB were 0.25 (small) and 0.05 (negligible). All three VAS items were strongly correlated (r=0.84-0.96).Participants interpreted health as clinical diagnoses, emphasizing physical health over mental/emotional health.Interpretations of HWB varied: complementary to health, indicating mental/emotional health, or redundant with health.QoL evoked broader assessments encompassing economic or social-relationship status. Most participants preferred having no specified recall period, allowing consideration of timeframes (e.g., 1-24 months) relevant to their experience.
CONCLUSIONS: Mixed-methods analyses offered insights into participants’ perceptions when interpreting VAS versions for health, social care, and carer related QoL. Qualitatively, HWB was perceived differently from health, yet quantitatively, resultswere similar. Further research in larger samples and other countries can help to inform the extent to which constructs and recall periods affect responses.
METHODS: US adults who were: 1) diagnosed with chronic illness; 2) unpaid caregivers; 3) social care users (e.g., received caregiving, living with disability) were recruited from ResearchMatch. In an online survey, three VAS variations were presented in a random order. Variations included no recall period with different constructs (‘quality of life’, ‘health’, and ‘health and well-being’) on a 0-100 scale. In an interview, participants discussed construct interpretation, appropriateness of recall periods (none, today, past 7 days), and whether these influenced their responses. Interviews were analyzed qualitatively through thematic analysis.
RESULTS: Thirty-four participants completed the survey and interview. Mean responses for QoL, health, and health and well-being (HWB) were 66.4 (SD=21.5), 61.9 (SD=21.3), and 60.9 (SD=21.8), respectively. Compared to health, effect sizes for QoL and HWB were 0.25 (small) and 0.05 (negligible). All three VAS items were strongly correlated (r=0.84-0.96).Participants interpreted health as clinical diagnoses, emphasizing physical health over mental/emotional health.Interpretations of HWB varied: complementary to health, indicating mental/emotional health, or redundant with health.QoL evoked broader assessments encompassing economic or social-relationship status. Most participants preferred having no specified recall period, allowing consideration of timeframes (e.g., 1-24 months) relevant to their experience.
CONCLUSIONS: Mixed-methods analyses offered insights into participants’ perceptions when interpreting VAS versions for health, social care, and carer related QoL. Qualitatively, HWB was perceived differently from health, yet quantitatively, resultswere similar. Further research in larger samples and other countries can help to inform the extent to which constructs and recall periods affect responses.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
P18
Topic
Patient-Centered Research
Topic Subcategory
Instrument Development, Validation, & Translation, Patient Engagement, Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas