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Rapid simultaneous comparison system for subjective grading scales grading scales for facial paralysis
A Ahrens1, D Skarada, M Wallace
1Department of Otolaryngology--Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110, USA.
Objective:
The senior authors developed a computer-assisted rapid, simultaneous comparison system for nine international grading scales for facial paralysis. The purpose of this study is to present the system and to compare the agreement of hand-performed House-Brackmann and Sunnybrook scales, two frequently used scales herein taken as the concurrent criterion test standards, with those like scales done simultaneously in the computed system.
Study Design:
The study design was a prospective concurrent criterion validity study. Test-retest reliability and interobserver agreement were assessed using the kappa statistic (k) for ordinal data and the intraclass correlation coefficient (ICC) for semidimensional data.
Setting:
The study was conducted at a university practice.
Patients:
Ten consecutive consenting subjects with varying degrees of facial paralysis were studied.
Intervention:
Each subject was measured, in random order, twice by each method by each of two independent observers.
Main Outcome Measures:
House-Brackmann score, Sunnybrook score, and like-scale scores done simultaneously in the computed system were measured.
Results:
Agreement between the computed system and hand-performed criterion standards was equal to each scale compared against itself; for the House-Brackmann, agreement was moderate (k = 0.554); for the Sunnybrook, agreement was excellent (ICC = 0.976).
Conclusions:
The computed system has the advantage of allowing an examiner to view a rapid, simultaneous display of multiple grading scale scores at a keystroke from one clinical assessment input, obviating the labor of repeating measures by hand.
