PMID- 27439316
OWN - NLM
STAT- MEDLINE
DCOM- 20170515
LR  - 20170515
IS  - 1468-3083 (Electronic)
IS  - 0926-9959 (Linking)
VI  - 31
IP  - 2
DP  - 2017 Feb
TI  - Reliability of the Patient and Observer Scar Assessment Scale and a 4-point scale 
      in evaluating linear facial surgical scars.
PG  - 341-346
LID - 10.1111/jdv.13805 [doi]
AB  - BACKGROUND: In order to evaluate and improve aesthetic outcome for patients 
      undergoing dermatological surgery, a reliable evaluation tool must be used. The 
      4-point scale and the Patient and Observer Scar Assessment Scale (POSAS) were 
      both developed for this purpose. OBJECTIVE: To compare the reliability of the 
      POSAS scale with the 4-point scale for facial linear surgical scars and to assess 
      the influence of different scar characteristics on the overall impression. 
      METHODS: Patients visiting the outpatient clinics of the Maastricht University 
      Medical Centre with linear facial scars were included. The 4-point scale and the 
      Observer Scar Assessment Scale (OSAS) were completed by three independent 
      observers. The Patient Scar Assessment Scale (PSAS) was completed by the patient 
      on the day of the visit and 2 weeks later. The intra-class correlation 
      coefficient (ICC) with corresponding 95% confidence intervals (CI) were 
      calculated to assess the reliability of the scales. Linear multivariate 
      regression analyses were performed to evaluate how the score on each aspect 
      affected the overall opinion. RESULTS: Fifty scars in 50 patients were included. 
      The ICC of the 4-point scale was 0.819 (95% CI: 0.708-0.892) for multiple 
      observers and 0.602 (95% CI: 0.447-0.734) for single observer. These were 
      superior to the ICCs of total OSAS scores (0.783 95% CI: 0.547-0.888 for multiple 
      observers and 0.546 95% CI: 0.287-0.726 for single observer). ICCs of individual 
      sub-items on the OSAS scored even lower. The sub-items contributed differently to 
      the overall opinion among the different observers or patient. CONCLUSION: In 
      terms of reliability, the overall opinion and the 4-point scale were superior to 
      the total POSAS score or the sub-items. Observers do not weight individual scar 
      characteristics equally to arrive at an overall opinion, which challenges the 
      assumption that calculating a total POSAS score by summing of the scores on the 
      individual items is a valid approach.
CI  - (c) 2016 European Academy of Dermatology and Venereology.
FAU - Liu, X
AU  - Liu X
AD  - Department of Dermatology, Maastricht University Medical Centre, Maastricht, The 
      Netherlands.
AD  - GROW, School for Oncology and Developmental Biology, Maastricht University 
      Medical Centre, Maastricht, The Netherlands.
FAU - Nelemans, P J
AU  - Nelemans PJ
AD  - Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
FAU - Van Winden, M
AU  - Van Winden M
AD  - Department of Surgery, St. Elisabeth Hospital Tilburg, Tilburg, The Netherlands.
AD  - Former student Maastricht University, The Netherlands.
FAU - Kelleners-Smeets, N W J
AU  - Kelleners-Smeets NW
AD  - Department of Dermatology, Maastricht University Medical Centre, Maastricht, The 
      Netherlands.
AD  - GROW, School for Oncology and Developmental Biology, Maastricht University 
      Medical Centre, Maastricht, The Netherlands.
FAU - Mosterd, K
AU  - Mosterd K
AD  - Department of Dermatology, Maastricht University Medical Centre, Maastricht, The 
      Netherlands.
AD  - GROW, School for Oncology and Developmental Biology, Maastricht University 
      Medical Centre, Maastricht, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20160721
PL  - England
TA  - J Eur Acad Dermatol Venereol
JT  - Journal of the European Academy of Dermatology and Venereology : JEADV
JID - 9216037
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Cicatrix
MH  - *Face
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Reproducibility of Results
EDAT- 2016/07/22 06:00
MHDA- 2017/05/16 06:00
CRDT- 2016/07/22 06:00
PHST- 2016/01/05 00:00 [received]
PHST- 2016/04/11 00:00 [accepted]
PHST- 2016/07/22 06:00 [pubmed]
PHST- 2017/05/16 06:00 [medline]
PHST- 2016/07/22 06:00 [entrez]
AID - 10.1111/jdv.13805 [doi]
PST - ppublish
SO  - J Eur Acad Dermatol Venereol. 2017 Feb;31(2):341-346. doi: 10.1111/jdv.13805. 
      Epub 2016 Jul 21.