The BARF scale. You know… for kids!

A new study presents and evaluates a way for nauseated children to indicate their level of medical distress (thanks to investigator Neil Gaiman for bringing it to our attention):

Development and Validation of a Pictorial Nausea Rating Scale for Children,” Amy L. Baxter [pictured below], Mehernoor F. Watcha, William Valentine Baxter, Traci Leong and Matthew M. Wyatt, Pediatrics, 127;2011, e1542. The authors, at Medical College of Georgia, Baylor College of Medicine, OLM Digital Inc. in Tokyo, Emory University, Baylor College of Medicine, and other institutions, report:


“This pictorial (Baxter Retching Faces) scale for measuring nausea severity has convergent and discriminant validity, and detected change after antiemetic treatment. Its use in the clinical and research setting may assist in nausea management in children…. To our knowledge, this is the first scale based in part on patient drawings.

“Additional studies will be required to determine if the stylized emesis anchor will decrease endorsement of the maximum nausea choice by patients with severe nausea but no emesis, based on concrete thinking that ‘If I am not actually vomiting, I cannot choose this face’….

“Future studies need to be performed to determine if there are age, gender, culture, ethnic, or language variations in the validation of the BARF scale.”

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