A modified Vancouver Scar Scale linked with TBSA (mVSS-TBSA): Inter-rater reliability of an innovative burn scar assessment method

作者：Gankande T U^*; Wood F M; Edgar D W; Duke J M; DeJong H M; Henderson A E; Wallace H J

来源：Burns, 2013, 39(6): 1142-1149.

DOI：10.1016/j.burns.2013.01.014

• Burns
• Scar assessment
• Inter-rater reliability

Background: Current scar assessment methods do not capture variation in scar outcome across the burn scar surface area. A new method (mVSS-TBSA) using a modified Vancouver Scar Scale (mVSS) linked with %TBSA was devised and inter-rater reliability was assessed. %26lt;br%26gt;Method: Three raters performed scar assessments on thirty patients with burn scars using the mVSS-TBSA. Scoring on pigmentation, vascularity, pliability and height was undertaken for the %26apos;best%26apos; and %26apos;worst%26apos; areas of each scar. Raters allocated the total body surface area of the scar (%TBSA) to three mVSS categories (%26lt;5, 5-10, %26gt;10). Intra-class correlation coefficient (ICC) and weighted kappa statistic (k(w)) were used to assess inter-rater reliability. The data were also analysed for clinically relevant misclassifications between pairs of raters. %26lt;br%26gt;Results: Total mVSS scores showed %26apos;fair to good%26apos; agreement (ICC 0.65-0.73) in the %26apos;best%26apos; area of the scar while there was %26apos;excellent%26apos; agreement in the %26apos;worst%26apos; scar area (ICC 0.85-0.88). The kw of the individual mVSS components ranged from 0.44 to 0.84 and 0.02 to 0.86 for %26apos;best%26apos; and %26apos;worst%26apos; scar areas, respectively. Determination of scar %TBSA had %26apos;excellent%26apos; reliability (ICC 0.91-0.96). Allocation of scar %TBSA to severity category %26lt;5 mVSS demonstrated %26apos;good to excellent%26apos; reliability (ICC 0.63-0.80) and %26apos;fair to good%26apos; reliability (ICC 0.42-0.74) for 5-10 mVSS category. However, misclassifications were observed for the total mVSS score in the %26apos;worst%26apos; scar area and the allocation of scar %TBSA in the %26lt;5 mVSS category. %26lt;br%26gt;Conclusion: Inter-rater reliability of mVSS scores depends on the severity of the scar area being assessed. The mVSS-TBSA method of allocation of scar %TBSA to two broad mVSS categories, namely %26lt;5 and %26gt;= 5 mVSS, has %26apos;good to excellent%26apos; reliability. The mVSS-TBSA has demonstrated utility for both clinical and research purposes; however, there is potential to misclassify scar outcome in some cases.

• 出版日期2013-9