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KMID : 1038220190460040359
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Archives of Plastic Surgery
2019 Volume.46 No. 4 p.359 ~ p.364
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A novel photonumeric hand grading scale for hand rejuvenation
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Lee Jong-Hun
Choi Yean-Su
Park Eun-Soo
Kim Jong-Seo
Kang Moon-Seok
Oh Hwa-Young
Yang So-Dam
Jeon Seon-Hui
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Abstract
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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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KEYWORD
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Asian continental ancestry group, Back, Hand, Rejuvenation, Skin aging
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