Centre for Dermatology Research, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K.
NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, U.K.
Br J Dermatol. 2018 May;178(5):1190-1195. doi: 10.1111/bjd.16331. Epub 2018 Mar 30.
Photonumeric scales have consistently shown superiority over descriptive equivalents. They have the advantage of providing a consistent visual frame of reference by minimizing variability in perception and subjectivity. A photonumeric scale to assess hypertrophic facial photodamage already exists. However, there is currently no objective measure for atrophic facial photodamage. To address this, we have devised a nine-point photonumeric standardized scale.
To design, test and validate a photonumeric scale for the assessment of atrophic facial photodamage against a descriptive scale for the same indication.
A pool of 393 facial photographs (en face and 45° oblique) from 131 individuals with atrophic facial photodamage was created. Five photographic standards were selected and assigned grades zero through to eight, where zero is no photodamage and eight is severe atrophic photodamage, thus making a nine-point scale. Twenty photographs spanning the entire range of values were selected to test the scale. Testing was performed alongside a descriptive equivalent. A panel of 10 dermatologists, 10 nondermatology clinicians and 14 dermatology scientists marked the two scales; marking was repeated 1 week later.
There was a significantly greater agreement between the graders using the photonumeric scale than the descriptive scale (kappa values 0·71 and 0·37 with standardized errors of 0·57 and 0·17, respectively) with no significant difference in repeatability between the two methods (P < 0·05).
The study describes a new photonumeric scale for atrophic photodamage. This would be a useful adjunct in both the clinical and research settings.
光子数字量表一直优于描述性量表。它们通过最小化感知和主观性的可变性，提供了一致的视觉参考框架的优势。已经存在一种用于评估肥大性面部光损伤的光子数字量表。然而，目前对于萎缩性面部光损伤还没有客观的测量方法。为了解决这个问题，我们设计了一种九分光子数字标准化量表。
设计、测试和验证一种用于评估萎缩性面部光损伤的光子数字量表，与同一适应症的描述性量表进行比较。
创建了一个由 131 名患有萎缩性面部光损伤的个体的 393 张面部照片（正面和 45°斜位）组成的照片库。选择了五个摄影标准，并将其分为零到八级，其中零级表示没有光损伤，八级表示严重的萎缩性光损伤，从而形成了一个九级量表。选择了二十张跨越整个值范围的照片来测试该量表。测试与描述性量表同时进行。一个由 10 名皮肤科医生、10 名非皮肤科临床医生和 14 名皮肤科科学家组成的小组对这两个量表进行了标记；一周后重复标记。
使用光子数字量表的评分者之间的一致性明显高于使用描述性量表的评分者（kappa 值分别为 0.71 和 0.37，标准误差分别为 0.57 和 0.17），两种方法的可重复性没有显著差异（P<0.05）。
本研究描述了一种用于萎缩性光损伤的新的光子数字量表。这将是临床和研究环境中的有用辅助工具。
