Day Doris J, Littler Curt M, Swift Richard W, Gottlieb Scott
Department of Dermatology, New York University Medical Center, New York, New York 10021, USA.
Am J Clin Dermatol. 2004;5(1):49-52. doi: 10.2165/00128071-200405010-00007.
Patient satisfaction is the most important outcome in facial aesthetic surgery. However, the need for evidence-based evaluation of aesthetic procedures dictates the use of more objective and quantitative measures of treatment outcome.
The present study was undertaken to validate a new clinical outcome instrument, the Wrinkle Severity Rating Scale.
Five clinical investigators were presented with 30 photographic images of the lower face and asked to rate nasolabial fold severity on each side using the 5-grade Wrinkle Severity Rating Scale (WSRS). Standardized definitions of the five grades were provided to the investigators in visual (photographic) and descriptive formats. To take into account possible facial asymmetry, nasolabial folds on the left and right sides of the face were rated separately. Assessments were conducted independently and were repeated after >or=2 weeks.
Intra-observer (test-retest) agreement was 68.7% (left side) and 72.7% (right side); weighted kappa coefficients for the left and right sides were 0.77 and 0.81, respectively. Mean inter-observer agreement (internal consistency) was 67.7% (left side) and 72.3% (right side); weighted kappa coefficients for the left and right sides were 0.75 (95% CI 0.70-0.79) and 0.78 (95% CI 0.72-0.83), respectively.
The WSRS is a valid and reliable instrument for quantitative assessment of facial skin folds, with good inter- and intra-observer consistency. By allowing objective and reproducible grading of data, the WSRS should prove a useful clinical tool for assessing the effectiveness of soft-tissue augmentation and other facial contouring procedures.
患者满意度是面部美容手术最重要的结果。然而，基于证据评估美容手术的必要性决定了需要使用更客观和定量的治疗结果衡量指标。
本研究旨在验证一种新的临床结果评估工具——皱纹严重程度评分量表。
向5名临床研究人员展示30张下脸部的照片，要求他们使用5级皱纹严重程度评分量表（WSRS）对每侧的鼻唇沟严重程度进行评分。以视觉（照片）和描述性格式向研究人员提供了五个等级的标准化定义。为了考虑可能存在的面部不对称，对面部左右两侧的鼻唇沟分别进行评分。评估独立进行，并在≥2周后重复。
观察者内（重测）一致性在左侧为68.7%，右侧为72.7%；左侧和右侧的加权kappa系数分别为0.77和0.81。观察者间平均一致性（内部一致性）在左侧为67.7%，右侧为72.3%；左侧和右侧的加权kappa系数分别为0.75（95%CI 0.70 - 0.79）和0.78（95%CI 0.72 - 0.83）。
WSRS是一种有效且可靠的用于定量评估面部皮肤褶皱的工具，具有良好的观察者间和观察者内一致性。通过允许对数据进行客观且可重复的分级，WSRS应被证明是评估软组织填充和其他面部轮廓整形手术效果的有用临床工具。
