Rapid simultaneous comparison system for subjective grading scales grading scales for facial paralysis.

OBJECTIVE

The senior authors developed a computer-assisted rapid, simultaneous comparison system for nine international grading scales for facial paralysis. The purpose of this study is to present the system and to compare the agreement of hand-performed House-Brackmann and Sunnybrook scales, two frequently used scales herein taken as the concurrent criterion test standards, with those like scales done simultaneously in the computed system.

STUDY DESIGN

The study design was a prospective concurrent criterion validity study. Test-retest reliability and interobserver agreement were assessed using the kappa statistic (k) for ordinal data and the intraclass correlation coefficient (ICC) for semidimensional data.

SETTING

The study was conducted at a university practice.

PATIENTS

Ten consecutive consenting subjects with varying degrees of facial paralysis were studied.

INTERVENTION

Each subject was measured, in random order, twice by each method by each of two independent observers.

MAIN OUTCOME MEASURES

House-Brackmann score, Sunnybrook score, and like-scale scores done simultaneously in the computed system were measured.

RESULTS

Agreement between the computed system and hand-performed criterion standards was equal to each scale compared against itself; for the House-Brackmann, agreement was moderate (k = 0.554); for the Sunnybrook, agreement was excellent (ICC = 0.976).

CONCLUSIONS

The computed system has the advantage of allowing an examiner to view a rapid, simultaneous display of multiple grading scale scores at a keystroke from one clinical assessment input, obviating the labor of repeating measures by hand.