Ponto Thellie, Benson Heather A E, Wright Anthony
Curtin Medical School, Curtin University, Perth, Australia.
School of Allied Health, Curtin University, Perth, Australia.
J Cosmet Dermatol. 2023 Mar;22(3):890-896. doi: 10.1111/jocd.15487. Epub 2022 Nov 28.
Numerous products and minimally-invasive procedures are available to reduce cellulite. However, there are a limited number of tools to evaluate the effects of these interventions and some are relatively complex to implement.
This study evaluated the reliability of a standardized grading system for scoring the overall severity of cellulite on the posterior thigh. The study evaluated inter-rater and intra-rater (test/re-test) reliability of the method and engaged in an iterative process to develop a reliable method to evaluate changes in the appearance of cellulite.
There were two stages in the validation process. The first stage was an open process without evaluator training. The second stage was a more controlled process with training given and moderator involvement to review grade selections. In the first stage, inter-rater reliability was examined across five evaluators who were asked to evaluate 24 photographs (right thighs) based on a cellulite graded severity chart. During the second stage, the same photographs were examined by paired evaluators who had received additional training. Scores were independently moderated by a third person. The inter-rater reliability and intra-rater reliability over a 4-week interval were evaluated using intraclass correlation coefficients (ICCs).
Twenty-four female participants (18-51 years, mean 31.68 ± 9.03 years) with a mean BMI of 29.04 ± 6.52 participated in the trial. Five female evaluators completed the initial evaluations. In stage 1, the inter-rater reliability (ICC ) was 0.838 (95%CI:0.700-0.922) and test/retest ICC values ranged from 0.360-0.990. In stage 2, the inter-rater reliability for 2 evaluators improved to 0.978 (95%CI:0.948-0.991), and the test/retest reliability of the moderated scoring method improved to 0.993 (95%CI:0.983-0.997).
The iterative process developed a simple and reliable method of rating cellulite severity, with excellent inter-and intra-rater reliability, based on evaluating images of cellulite against a standard set of graded severity images. A reliable method of assessing cellulite severity is essential for undertaking future clinical trials to evaluate cellulite treatments.
有许多产品和微创手术可用于减少橘皮组织。然而，用于评估这些干预措施效果的工具数量有限，且有些实施起来相对复杂。
本研究评估了一种标准化分级系统对大腿后侧橘皮组织总体严重程度评分的可靠性。该研究评估了该方法的评分者间信度和评分者内信度（测试/重测），并进行了一个迭代过程，以开发一种可靠的方法来评估橘皮组织外观的变化。
验证过程分两个阶段。第一阶段是一个无评估者培训的开放过程。第二阶段是一个更可控的过程，提供培训并由主持人参与审查分级选择。在第一阶段，对五名评估者的评分者间信度进行了检查，要求他们根据橘皮组织分级严重程度图表评估24张照片（右大腿）。在第二阶段，由接受过额外培训的配对评估者检查相同的照片。分数由第三人独立审核。使用组内相关系数（ICC）评估4周间隔内的评分者间信度和评分者内信度。
24名女性参与者（18 - 51岁，平均31.68±9.03岁）参与了试验，平均BMI为29.04±6.52。五名女性评估者完成了初始评估。在第一阶段，评分者间信度（ICC）为0.838（95%CI：0.700 - 0.922），测试/重测ICC值范围为0.360 - 0.990。在第二阶段，两名评估者的评分者间信度提高到0.978（95%CI：0.948 - 0.991），审核评分方法的测试/重测信度提高到0.993（95%CI：0.983 - 0.997）。
该迭代过程开发了一种简单可靠的橘皮组织严重程度评级方法，基于对照一组标准的分级严重程度图像评估橘皮组织图像，具有出色的评分者间和评分者内信度。一种可靠的评估橘皮组织严重程度的方法对于开展未来评估橘皮组织治疗的临床试验至关重要。
