Short communication Validation of a new hand-held electronic appetite rating system against the pen and paper method Eva Almiron-Roig 1 , Hilary Green, Robert Virgili, Jean-Marc Aeschlimann, Mireille Moser, Alfrun Erkner * Nestle ´ Research Centre, Vers-Chez-les Blanc, CH-1000 Lausanne 26, Switzerland Introduction The visual analogue scale (VAS) is a type of psychometric scale employed to measure pain, quality of life and food-related attributes (Stubbs et al., 2000). A typical VAS consists of a motivational question followed by a straight line (100–150 mm), with two extreme statements anchored at either end. The subject is asked to respond to the question by drawing a trait across the line. Hill and Blundell (1982) developed a paper-based questionnaire with 6 motivational questions addressing hunger, fullness, desire to eat, prospective eating, urge to eat and preoccupation with thoughts of food. These questions and slight variations of them have been applied to a large body of appetite research (Mattes, Hollis, Hayes, & Stunkard, 2005). Traditionally, VAS is presented in a way that reduces the chance of the subject reffering back to a previous question. This involves either close supervision of the subjects or presentation of the scales in individual envelopes. Those methods are time-consuming, can lead to missing data, increased variability, and errors in the transfer to appropriate spreadsheets for analysis (Stubbs et al., 2000). To overcome these inconveniences, portable electronic methods were developed that shorten the processing time and allow the subject to leave the experimental room (Stubbs et al., 2000). A meta-analysis by Gwaltney, Shields, and Shiffman (2008) comparing paper assessment of patient-recorded outcomes against electronic assessment, concluded that electronic methods produce equivalent scores to paper methods. However, the majority of studies included did not use VAS and many tools related to assessment of clinical aspects rather than appetite. Electronic assessments, validated against paper methods for appetite studies, are not available anymore (Stubbs et al., 2000, 2001). Adaptation of VAS to portable computer screens usually involves the shortening of the scales (<100 mm). This has been shown to decrease sensitivity when comparing them to paper-based 100 or 150 mm scales, due to ‘‘end of scale’’ effects (subjects tend to avoid extremes; Stone & Sidel, 2004). Whybrow, Stephen, and Stubbs (2006) compared a 52 mm electronic VAS on Palm computers with paper VAS. Both methods produced comparable results, but were not interchangeable. A significant bias, mainly due to end-effects, existed between the methods for 5 out of 9 questions. This study presents the validation of a novel appetite rating software created at the Nestle ´ Research Centre. Five traditional appetite questions (Hill & Blundell, 1982) were tested against an equivalent 100 mm paper VAS. The software was designed to allow automatic data capture and downloading into configurable Excel spread sheets in order to reduce time for data processing. Methods Subjects Healthy men (n = 11) and women (n = 19), all employees from Nestec S.A. (Switzerland), participated in the study ‘‘to validate a new method to collect dietary data’’. Subject exclusion criteria included: BMI < 19.0 or >27.0 kg/m 2 ; pregnant; lactating; smo- ker; consuming a diet/supplements to gain/lose weight; perform- ing strenuous regular physical activity; disliking the foods served; Appetite 53 (2009) 465–468 ARTICLE INFO Article history: Received 12 June 2009 Received in revised form 22 September 2009 Accepted 23 September 2009 Keywords: Visual analogue scale Electronic appetite rating system ABSTRACT This study describes the validation of a new electronic appetite rating system, and a statistical variance model for visual analogue scale (VAS) research. Thirty volunteers rated hunger, fullness, desire to eat, prospective intake, thirst and liking on 100 mm paper VAS and on 70 mm electronic VAS presented on a Dell TM Pocket PC, after consuming breakfast, in a repeated trial. The electronic method was comparable in relative accuracy and reproducibility to the paper method, with weak differences between tests (within-subject SD  14 mm). The data obtained were used to generate a model for VAS data variability. ß 2009 Elsevier Ltd. All rights reserved. * Corresponding author. E-mail address: alfrun.erkner@rdls.nestle.com (A. Erkner). 1 Present address: Dept. of Biological Sciences, University of Chester, Parkgate Road, Chester CH1 4BJ, United Kingdom. Contents lists available at ScienceDirect Appetite journal homepage: www.elsevier.com/locate/appet 0195-6663/$ – see front matter ß 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.appet.2009.09.014