Rickenmann J, Jaquenod C, Cerenko D, Fisch U
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital, Zurich, Switzerland.
Otolaryngol Head Neck Surg. 1997 Oct;117(4):322-5. doi: 10.1016/S0194-5998(97)70120-7.
The Fisch Detailed Evaluation of Facial Symmetry (DEFS) and House-Brackmann grading system (HBGS) were compared by statistical examination for their reliability and interobserver variability. Furthermore, the correlation and agreement with a standard global evaluation were compared. Therefore 47 patients with facial palsy of different cause have been evaluated with the two systems, and the global overall evaluation was done by five otolaryngologists familiar with facial palsy. The DEFS showed a high reliability of 0.93 compared with a reliability of 0.77 with the HBGS (international standard requires a reliability of at least 0.8). The mean interobserver variability is 5.24% (SD = 3.2%) with the DEFS and 9.26% (SD = 5.0%) with the HBGS; with a confidence interval of 95%, it is 11.6% and 19.26%. The correlation of both gradings with the global evaluation was high, with r = 0.98 and r = 0.97. The DEFS shows an excellent agreement with the global overall evaluation in 41 (87%) of 47 cases and the HBGS in 32 (66%) of 47 cases.
通过统计学检验比较了面部对称性详细评估（Fisch DEFS）和House-Brackmann分级系统（HBGS）的可靠性及观察者间变异性。此外，还比较了这两种系统与标准整体评估的相关性及一致性。因此，使用这两种系统对47例不同病因的面瘫患者进行了评估，并由5位熟悉面瘫情况的耳鼻喉科医生进行整体评估。与HBGS可靠性为0.77相比，Fisch DEFS显示出0.93的高可靠性（国际标准要求可靠性至少为0.8）。Fisch DEFS观察者间平均变异性为5.24%（标准差=3.2%），HBGS为9.26%（标准差=5.0%）；95%置信区间分别为11.6%和19.26%。两种分级与整体评估的相关性都很高，r值分别为0.98和0.97。Fisch DEFS在47例中的41例（87%）与整体评估具有极佳一致性，HBGS在47例中的32例（66%）与整体评估具有极佳一致性。
