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Measuring the severity of infantile hemangiomas: instrument development and reliability
Anita N Haggstrom1, Jennifer L Beaumont, Jin-She Lai
1Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Objectives:
To develop instruments that measure the severity of infantile hemangiomas (Hemangioma Severity Scale [HSS]) and the complications of infantile hemangiomas for longitudinal use (Hemangioma Dynamic Complication Scale [HDCS]).
Design:
Instrument development and reliability study.
Setting:
Academic research.
Participants:
The HSS and the HDCS were developed through the collaborative effort of members of the Hemangioma Investigator Group Research Core, an expert multi-institutional research group. After development of the scales, 13 pediatric dermatologists used the HSS to score 20 different hemangiomas. In addition, 12 pediatric dermatologists used the HDCS to score hemangioma-related complications for 24 clinical scenarios. Interrater and intrarater reliability was measured for both scales.
Main Outcome Measures:
Interrater and intrarater reliability.
Results:
For the HSS, interrater reliability and intrarater reliability exceeded 99%. Similarly, the HDCS had a high rate of interrater agreement; for individual items, agreement among raters was 67% to 100%, with most clinical scenarios demonstrating greater than 90% agreement. Intrarater reliability was excellent for all individual items of the HDCS.
Conclusion:
The HSS and the HDCS are reliable scales that can be used to measure the severity of infantile hemangiomas, including the severity of complications for longitudinal use.
