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DOI: 10.5999/aps.2019.00521
A novel photonumeric hand grading scale for hand rejuvenation
This work was supported by Life Sciences R&D, LG Chem, Ltd.
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.
The authors acknowledge and thank the following members of the scale validation group for completing the scale validation: Kook Hyun Kim, MD, Byungkwan Shim, MD, Han Jeong Lee, MD, Seok Min Choi, MD, and Han Gyu Cha, MD.
Publication History
Received: 06 May 2019
Accepted: 10 July 2019
Article published online:
28 March 2022
© 2019. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
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