Begic Anadi, Stark Birgit
Department of Plastic Surgery, Telemark Hospital, Skien, Norway; and Department for Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Plast Reconstr Surg Glob Open. 2017 Feb 22;5(2):e1240. doi: 10.1097/GOX.0000000000001240. eCollection 2017 Feb.
"Telemark Breast Score" (TBS) has been developed at Telemark Hospital in Norway for evaluation of results after breast surgery based on standardized patients' photographs taken as a part of daily routine. Its reliability has recently been tested and approved. The external validity of the TBS was assessed by matching its data against the internationally recognized Breast-Q (BQ) questionnaire as a further step to study the validity of this new tool.
The ideal distribution of breast volume is 45% of the total volume above and 55% below the nipple, and a 40° slope line at the upper pole. TBS makes the evaluation of these parameters of breast aesthetics more explicit. The method has been tested on photographs from 31 patients operated on for breast cancer with the Deep Inferior Perforator Flap. The evaluation was done by an independent experienced plastic surgeon earlier participating in the test-retests. The external validity of TBS was investigated against domains 1 and 3 of the BQ reconstruction module. The concordance between ratings was analyzed.
Concordance between TBS items and BQ domain 1 items regarding patient satisfaction, and between TBS items and BQ domain 3 items regarding how the patient experienced the outcome of breast reconstruction was relatively high except for 6 comparisons where we could not statistically ensure that more pairs were concordant than discordant. A total of 178 comparisons appeared to be concordant. This means that for all other comparisons, there was a preponderance of pairs of concordant observations, which indicates that measurements from the 2 instruments follow each other.
The present data indicate that the TBS can be recommended as a valid tool to professionals for assessment of the outcome after breast reconstruction.
“泰勒马克乳房评分”（TBS）由挪威泰勒马克医院开发，用于根据日常拍摄的标准化患者照片评估乳房手术后的效果。其可靠性最近已得到测试和认可。作为研究这一新工具有效性的进一步步骤，通过将TBS数据与国际认可的乳房-Q（BQ）问卷进行匹配，评估了TBS的外部有效性。
理想的乳房体积分布是乳头上方占总体积的45%，乳头下方占55%，上极有一条40°的斜线。TBS使乳房美学这些参数的评估更加明确。该方法已在31例接受腹壁下深动脉穿支皮瓣乳房手术患者的照片上进行了测试。评估由一名较早参与重测的独立经验丰富的整形外科医生进行。针对BQ重建模块的第1和第3领域研究了TBS的外部有效性。分析了评分之间的一致性。
除了6项比较中我们无法从统计学上确保一致的配对多于不一致的配对外，TBS项目与BQ第1领域项目在患者满意度方面，以及TBS项目与BQ第3领域项目在患者对乳房重建结果的体验方面的一致性相对较高。总共178项比较似乎是一致的。这意味着对于所有其他比较，一致观察的配对占优势，这表明两种工具的测量结果相互一致。
目前的数据表明，TBS可作为一种有效的工具推荐给专业人员，用于评估乳房重建后的效果。
