Reliable scar scoring system to assess photographs of burn patients

Gabriel A. Mecott, Celeste Finnerty, David Herndon, Ahmed M. Al-Mousawi, Ludwik Branski, Sachin Hegde, Robert Kraft, Felicia N. Williams, Susana A. Maldonado, Haidy G. Rivero, Noe Rodriguez-Escobar, Marc G. Jeschke

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Several scar-scoring scales exist to clinically monitor burn scar development and maturation. Although scoring scars through direct clinical examination is ideal, scars must sometimes be scored from photographs. No scar scale currently exists for the latter purpose. Materials and methods: We modified a previously described scar scale (Yeong etal., J Burn Care Rehabil 1997) and tested the reliability of this new scale in assessing burn scars from photographs. The new scale consisted of three parameters as follows: scar height, surface appearance, and color mismatch. Each parameter was assigned a score of 1 (best) to 4 (worst), generating a total score of 3-12. Five physicians with burns training scored 120 representative photographs using the original and modified scales. Reliability was analyzed using coefficient of agreement, Cronbach alpha, intraclass correlation coefficient, variance, and coefficient of variance. Analysis of variance was performed using the Kruskal-Wallis test. Color mismatch and scar height scores were validated by analyzing actual height and color differences. Results: The intraclass correlation coefficient, the coefficient of agreement, and Cronbach alpha were higher for the modified scale than those of the original scale. The original scale produced more variance than that in the modified scale. Subanalysis demonstrated that, for all categories, the modified scale had greater correlation and reliability than the original scale. The correlation between color mismatch scores and actual color differences was 0.84 and between scar height scores and actual height was 0.81. Conclusions: The modified scar scale is a simple, reliable, and useful scale for evaluating photographs of burn patients.

Original languageEnglish (US)
JournalJournal of Surgical Research
DOIs
StateAccepted/In press - Jan 18 2013

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Cicatrix
Color
Burns
Analysis of Variance
Physicians

Keywords

  • Burn
  • Hypertrophic scar
  • Photograph
  • Scale
  • Scar

ASJC Scopus subject areas

  • Surgery

Cite this

Reliable scar scoring system to assess photographs of burn patients. / Mecott, Gabriel A.; Finnerty, Celeste; Herndon, David; Al-Mousawi, Ahmed M.; Branski, Ludwik; Hegde, Sachin; Kraft, Robert; Williams, Felicia N.; Maldonado, Susana A.; Rivero, Haidy G.; Rodriguez-Escobar, Noe; Jeschke, Marc G.

In: Journal of Surgical Research, 18.01.2013.

Research output: Contribution to journalArticle

Mecott, GA, Finnerty, C, Herndon, D, Al-Mousawi, AM, Branski, L, Hegde, S, Kraft, R, Williams, FN, Maldonado, SA, Rivero, HG, Rodriguez-Escobar, N & Jeschke, MG 2013, 'Reliable scar scoring system to assess photographs of burn patients', Journal of Surgical Research. https://doi.org/10.1016/j.jss.2014.10.055
Mecott, Gabriel A. ; Finnerty, Celeste ; Herndon, David ; Al-Mousawi, Ahmed M. ; Branski, Ludwik ; Hegde, Sachin ; Kraft, Robert ; Williams, Felicia N. ; Maldonado, Susana A. ; Rivero, Haidy G. ; Rodriguez-Escobar, Noe ; Jeschke, Marc G. / Reliable scar scoring system to assess photographs of burn patients. In: Journal of Surgical Research. 2013.
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abstract = "Background: Several scar-scoring scales exist to clinically monitor burn scar development and maturation. Although scoring scars through direct clinical examination is ideal, scars must sometimes be scored from photographs. No scar scale currently exists for the latter purpose. Materials and methods: We modified a previously described scar scale (Yeong etal., J Burn Care Rehabil 1997) and tested the reliability of this new scale in assessing burn scars from photographs. The new scale consisted of three parameters as follows: scar height, surface appearance, and color mismatch. Each parameter was assigned a score of 1 (best) to 4 (worst), generating a total score of 3-12. Five physicians with burns training scored 120 representative photographs using the original and modified scales. Reliability was analyzed using coefficient of agreement, Cronbach alpha, intraclass correlation coefficient, variance, and coefficient of variance. Analysis of variance was performed using the Kruskal-Wallis test. Color mismatch and scar height scores were validated by analyzing actual height and color differences. Results: The intraclass correlation coefficient, the coefficient of agreement, and Cronbach alpha were higher for the modified scale than those of the original scale. The original scale produced more variance than that in the modified scale. Subanalysis demonstrated that, for all categories, the modified scale had greater correlation and reliability than the original scale. The correlation between color mismatch scores and actual color differences was 0.84 and between scar height scores and actual height was 0.81. Conclusions: The modified scar scale is a simple, reliable, and useful scale for evaluating photographs of burn patients.",
keywords = "Burn, Hypertrophic scar, Photograph, Scale, Scar",
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AU - Finnerty, Celeste

AU - Herndon, David

AU - Al-Mousawi, Ahmed M.

AU - Branski, Ludwik

AU - Hegde, Sachin

AU - Kraft, Robert

AU - Williams, Felicia N.

AU - Maldonado, Susana A.

AU - Rivero, Haidy G.

AU - Rodriguez-Escobar, Noe

AU - Jeschke, Marc G.

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N2 - Background: Several scar-scoring scales exist to clinically monitor burn scar development and maturation. Although scoring scars through direct clinical examination is ideal, scars must sometimes be scored from photographs. No scar scale currently exists for the latter purpose. Materials and methods: We modified a previously described scar scale (Yeong etal., J Burn Care Rehabil 1997) and tested the reliability of this new scale in assessing burn scars from photographs. The new scale consisted of three parameters as follows: scar height, surface appearance, and color mismatch. Each parameter was assigned a score of 1 (best) to 4 (worst), generating a total score of 3-12. Five physicians with burns training scored 120 representative photographs using the original and modified scales. Reliability was analyzed using coefficient of agreement, Cronbach alpha, intraclass correlation coefficient, variance, and coefficient of variance. Analysis of variance was performed using the Kruskal-Wallis test. Color mismatch and scar height scores were validated by analyzing actual height and color differences. Results: The intraclass correlation coefficient, the coefficient of agreement, and Cronbach alpha were higher for the modified scale than those of the original scale. The original scale produced more variance than that in the modified scale. Subanalysis demonstrated that, for all categories, the modified scale had greater correlation and reliability than the original scale. The correlation between color mismatch scores and actual color differences was 0.84 and between scar height scores and actual height was 0.81. Conclusions: The modified scar scale is a simple, reliable, and useful scale for evaluating photographs of burn patients.

AB - Background: Several scar-scoring scales exist to clinically monitor burn scar development and maturation. Although scoring scars through direct clinical examination is ideal, scars must sometimes be scored from photographs. No scar scale currently exists for the latter purpose. Materials and methods: We modified a previously described scar scale (Yeong etal., J Burn Care Rehabil 1997) and tested the reliability of this new scale in assessing burn scars from photographs. The new scale consisted of three parameters as follows: scar height, surface appearance, and color mismatch. Each parameter was assigned a score of 1 (best) to 4 (worst), generating a total score of 3-12. Five physicians with burns training scored 120 representative photographs using the original and modified scales. Reliability was analyzed using coefficient of agreement, Cronbach alpha, intraclass correlation coefficient, variance, and coefficient of variance. Analysis of variance was performed using the Kruskal-Wallis test. Color mismatch and scar height scores were validated by analyzing actual height and color differences. Results: The intraclass correlation coefficient, the coefficient of agreement, and Cronbach alpha were higher for the modified scale than those of the original scale. The original scale produced more variance than that in the modified scale. Subanalysis demonstrated that, for all categories, the modified scale had greater correlation and reliability than the original scale. The correlation between color mismatch scores and actual color differences was 0.84 and between scar height scores and actual height was 0.81. Conclusions: The modified scar scale is a simple, reliable, and useful scale for evaluating photographs of burn patients.

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KW - Hypertrophic scar

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