Arch Plast Surg.
2019 Jul;46(4):359-364. 10.5999/aps.2019.00521.
A novel photonumeric hand grading scale for hand rejuvenation
- Affiliations
-
- 1Department of Plastic and Reconstructive Surgery, Nowon Eulji Medical Center, Eulji University School of College, Seoul, Korea.
- 2Department of Plastic and Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea. peunsoo@schmc.ac.kr
- 3Kim Jongseo Plastic Surgery Clinic, Seoul, Korea.
- 4Garosu Plastic and Aesthetic Surgery Clinic, Seoul, Korea.
- 5Jayjun Plastic and Aesthetic Surgery Clinic, Seoul, Korea.
- 6Life Sciences R&D, LG Chem, Ltd., Seoul, Korea.
- KMID: 2459663
- DOI: http://doi.org/10.5999/aps.2019.00521
Abstract
- BACKGROUND
Few scales are currently available to evaluate changes in hand volume. We aimed to develop a hand grading scale for quantitative assessments of dorsal hand volume with additional consideration of changes in skin texture; to validate and prove the precision and reproducibility of the new scale; and to demonstrate the presence of clinically significant differences between grades on the scale.
METHODS
Five experienced plastic surgeons developed the Hand Volume Rating Scale (HVRS) and rated 91 images. Another five plastic surgeons validated the scale using 50 randomly selected images. Intra- and inter-rater agreement was calculated using the weighted kappa statistic and intraclass correlation coefficients (ICCs). Paired images were also evaluated to verify whether the scale reflected clinical differences.
RESULTS
The intra-rater agreement was 0.95 (95% confidence interval, 0.922-0.974). The interrater ICCs were excellent (first rating, 0.94; second rating, 0.94). Image pairs that differed by 1, 2, and 3 grades were considered to contain clinically relevant differences in 80%, 100%, and 100% of cases, respectively, while 84% of image pairs of the same grade were found not to show clinically relevant differences. This confirmed that the scale of the HVRS corresponded to clinically relevant distinctions.
CONCLUSIONS
The scale was proven to be precise, reproducible, and reflective of clinical differences.
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