35Pictorial Scale
Drawing pictures or clipart can be used to express feelings and emotions items in a
PROM instrument. They illustrate the rating scale in a more approachable way,
especially within a population with a low level of literacy (Fig. 2.2).
Visual Analog Scale
A psychometric tool measuring that can be used to assess a rather subjective out-
come such as feeling pain, happiness, or any characteristic or attitude that cannot be
measured in a direct way (Fig. 2.3).
Fig. 2.2 Pictorial scale illustrating different levels of pain as clipart facial expressions
Fig. 2.3 Visual analog scale displaying, on a 10-point scale, the state of distress exerted by a
respondent
2 A Guide to PROMs Methodology and Selection Criteria