Parker Wendy L, Czerwinski Marcin, Sinno Hani, Loizides Photis, Lee Chen
Montreal, Quebec, Canada From the Division of Plastic Surgery, Montreal Children's Hospital.
Plast Reconstr Surg. 2007 Oct;120(5):1419-1423. doi: 10.1097/01.prs.0000279390.73401.de.
Subjective interpretation of preoperative and postoperative photographs is heavily relied on for evaluating standards of care. For preoperative and postoperative digital images to accurately reflect surgical outcomes, image characteristics, other than acquisition, must be rigidly standardized. The authors investigated, using objective methodology, the consistency of published images within the plastic surgery literature.
A panel reviewed four plastic surgery journals (Aesthetic Plastic Surgery, Aesthetic Surgery Journal, Plastic and Reconstructive Surgery, and the British Journal of Plastic Surgery), with 100 consecutive, color, digital, paired preoperative and postoperative images per journal compared. Image characteristics, including color, brightness, contrast, resolution, view, zoom, size, image labeling, background, patient clothing, accessories, makeup/tan, facial expression, and hairstyle, were objectively assessed using a five-point Likert scale; mean values were tabulated and compared among journals; and statistical significance was determined (p < 0.05).
The most consistent characteristics among journals included labeling (4.782) and size (4.867), in contrast to clothing (3.097) and hairstyle (3.724) (p < 0.001). Much variability was also present in color, brightness, and view. Plastic and Reconstructive Surgery and American Aesthetic Plastic Surgery were the two most consistent journals when all image characteristics were combined, scoring 4.6 and 4.5, respectively (p <or= 0.01).
Standardization of photographic images is essential in plastic surgery for validity of results. Overall, the authors have demonstrated that much variability exists for all image characteristics between preoperative and postoperative images. Many are crucial to the evaluation of the surgical outcome depicted. In a specialty with a dramatically increasing trend toward communication by means of digital imaging, an effort toward standardization is essential.
术前和术后照片的主观解读在很大程度上依赖于护理标准的评估。为了使术前和术后数字图像准确反映手术效果，除采集外的图像特征必须严格标准化。作者采用客观方法研究了整形外科学术文献中已发表图像的一致性。
一个小组审查了四本整形外科学期刊（《美容整形外科学》《美容外科杂志》《整形与重建外科杂志》以及《英国整形外科学杂志》），每本期刊比较了连续的100对彩色数字术前和术后图像。使用五点李克特量表对图像特征进行客观评估，包括颜色、亮度、对比度、分辨率、视图、缩放、尺寸、图像标注、背景、患者服装、配饰、妆容/晒黑、面部表情和发型；列出平均值并在各期刊之间进行比较；确定统计学意义（p<0.05）。
各期刊之间最一致的特征包括标注（4.782）和尺寸（4.867），而服装（3.097）和发型（3.724）则不一致（p<0.001）。颜色、亮度和视图也存在很大差异。当综合所有图像特征时，《整形与重建外科杂志》和《美国美容整形外科学杂志》是最一致的两本期刊，得分分别为4.6和4.5（p≤0.01）。
整形手术中照片图像的标准化对于结果的有效性至关重要。总体而言，作者已经证明术前和术后图像之间所有图像特征都存在很大差异。其中许多特征对于所描绘手术效果的评估至关重要。在一个通过数字成像进行交流的趋势急剧增加的专业领域，努力实现标准化至关重要。
