*Director, AboutSkin Dermatology and DermSurgery, Englewood, Colorado; †Allergan, Inc., Santa Barbara, California; ‡Assistant Clinical Professor of Medicine/Dermatology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; §Private Practice, Newport Beach, California; ‖Private Practice, Santa Barbara, California; ¶Allergan, Inc., Irvine, California; #SCI Scientific Communications and Information. J.T. and F.C.B. are in Kythera Biopharmaceuticals, Calabasas, California. P.S.W. Kythera Biopharmaceuticals, Agoura Hills, California.
Dermatol Surg. 2014 Jun;40(6):663-70. doi: 10.1111/dsu.0000000000000008.
Validated aesthetic rating scales for the perioral area provide objective evaluations for clinical trials and practice.
To confirm the reliability of 3 scales for evaluating dermal filler and neurotoxin treatments of the perioral area.
Three lip-specific photographic scales were developed from standardized 2-dimensional images to evaluate Perioral Lines at Rest (POL), Oral Commissures (OCS), and Perioral Lines at Maximum Contraction (POLM) severity scales. Each 4-grade scale (none to severe) had 3 representative images per grade. Physician validators rated volunteers on each scale (2 rounds of live review). Volunteers provided 2 series of self-assessments. Physician and subject intrarater reliability were based on the comparison of round 1 and round 2 scores (mean weighted kappa coefficient). Other measures were physician interrater agreement (intraclass correlation) and subject/physician interrater agreement (Pearson correlation).
Physician intrarater agreement was almost perfect or substantial (POL, 0.725; OCS, 0.789; POLM, 0.826). Overall, physician interrater agreement was almost perfect for all 3 scales and ranged from moderate to substantial by grade. Subject intrarater agreement and subject/physician interrater agreement were substantial.
All scales demonstrated a high degree of intrarater and interrater reliability during the validation process. Physician concordance was good; subject ratings were reliable and comparable to physician assessments.
经过验证的口周区域美学评分量表为临床试验和实践提供了客观评估。
确认 3 种用于评估口周区域真皮填充剂和神经毒素治疗的评分量表的可靠性。
从标准化的 2 维图像中开发了 3 种唇部专用摄影量表，以评估静止时口周线（POL）、口角（OCS）和最大收缩时口周线（POLM）严重程度。每个 4 级量表（从无到严重）在每个级别都有 3 个代表性图像。医生验证者对每个量表上的志愿者进行评分（2 轮现场审查）。志愿者对每个量表进行了 2 系列自我评估。医生和受试者的内部评估者可靠性是基于第一轮和第二轮评分的比较（平均加权kappa 系数）。其他措施包括医生间的一致性（组内相关系数）和受试者/医生间的一致性（Pearson 相关系数）。
医生的内部评估者一致性几乎是完美或显著的（POL，0.725；OCS，0.789；POLM，0.826）。总的来说，所有 3 个量表的医生间评估者一致性几乎都是完美的，且按等级从中度到显著不等。受试者的内部评估者一致性和受试者/医生间的评估者一致性均为显著。
在验证过程中，所有量表都表现出高度的内部评估者和外部评估者可靠性。医生的一致性较好；受试者的评分是可靠的，且与医生的评估具有可比性。
