Tan Jerry K L, Tang Jing
J Clin Aesthet Dermatol. 2010 Jun;3(6):35-8.
The scientific integrity of outcome measurements is dependent upon reproducibility and accuracy. In acne assessments, there is no current gold standard for accuracy in lesion counting and global grading.
The purpose of this study was to create facial acne replicas for use in acne training and for evaluation of rater accuracy.
Two full-sized, three-dimensional, silicone-based, facial replicas with predetermined acne lesion type and number were created. Their teaching value was evaluated by dermatologists and clinical coordinators undergoing training in acne evaluations. A questionnaire after the training session addressed realism, preferences, and ease of assessments with the facial replicas compared to live subjects.
Of 55 potential respondents, 32 questionnaires were completed and analyzable. Of these, 23 were from dermatologists and nine were from clinical research coordinators performing acne assessments. The facial replicas were considered sufficiently realistic for acne lesion counting by 91 percent (29/32) and for global grading by 94 percent (30/32). Of these, 66 percent preferred to have both real subjects and replicas for training (21/32), 31 percent preferred real subjects only (9/32), and one preferred replicas only. Replicas were considered easier to evaluate for noninflammatory and inflammatory lesions (p=0.002 and p=0.013, respectively) and equivalent to live models for global grading (p=0.001).
Shortcomings include the limited spectrum of acne that could be represented due to production of only two prototypes, the relative paucity of secondary lesions, and production time and cost.
These facial replicas provide a realistic and practical method for teaching and evaluating raters in acne outcome measures as they provide a gold standard for acne lesion counts. Furthermore, their use may obviate some of the shortcomings inherent in recruitment of human acne volunteers for acne training sessions.
结果测量的科学完整性取决于可重复性和准确性。在痤疮评估中，目前在皮损计数和整体分级的准确性方面没有金标准。
本研究的目的是制作面部痤疮复制品，用于痤疮培训和评估评分者的准确性。
制作了两个具有预定痤疮皮损类型和数量的全尺寸、三维、硅基面部复制品。皮肤科医生和接受痤疮评估培训的临床协调员对其教学价值进行了评估。培训课程后的一份问卷涉及与活体受试者相比，面部复制品的逼真度、偏好程度以及评估的难易程度。
在55名潜在受访者中，32份问卷填写完整且可分析。其中，23份来自皮肤科医生，9份来自进行痤疮评估的临床研究协调员。91%（29/32）的人认为面部复制品对于痤疮皮损计数足够逼真，94%（30/32）的人认为对于整体分级足够逼真。其中，66%的人更喜欢同时使用真实受试者和复制品进行培训（21/32），31%的人只喜欢真实受试者（9/32），1人只喜欢复制品。对于非炎性和炎性皮损，复制品被认为更易于评估（分别为p = 0.002和p = 0.013），对于整体分级与活体模型相当（p = 0.001）。
缺点包括由于仅制作了两个原型，所能呈现的痤疮范围有限，继发性皮损相对较少，以及制作时间和成本。
这些面部复制品为痤疮结果测量的评分者教学和评估提供了一种现实可行的方法，因为它们为痤疮皮损计数提供了金标准。此外，使用它们可能会消除在招募人类痤疮志愿者进行痤疮培训课程时固有的一些缺点。
