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Development and Validation of a Photonumeric Scale for Evaluation of Transverse Neck Lines
Derek Jones1, Alastair Carruthers, Bhushan Hardas
1*Division of Dermatology, University of California at Los Angeles, Los Angeles, California; †Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; ‡Allergan plc, Irvine, California; §UC Davis Medical Group, Sacramento, California; ‖Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut; ¶Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada; #Peloton Advantage, LLC, Parsippany, New Jersey.
Background:
A validated scale is needed for objective and reproducible comparisons of horizontal neck lines before and after treatment in practice and clinical studies.
Objective:
To describe the development and validation of the 5-point photonumeric Allergan Transverse Neck Lines Scale.
Methods:
The Allergan Transverse Neck Lines Scale was developed to include an assessment guide, verbal descriptors, morphed images, and real subject images for each scale grade. The clinical significance of a 1-point score difference was evaluated in a review of multiple image pairs representing varying differences in severity. Interrater and intrarater reliability was evaluated in a live-subject rating validation study (N = 297) completed during 2 sessions occurring 3 weeks apart.
Results:
A difference of ≥1 point on the scale was shown to reflect a clinically significant difference (mean [95% confidence interval] absolute score difference, 1.22 [1.09-1.35] for clinically different image pairs and 0.57 [0.42-0.72] for not clinically different pairs). Intrarater agreement between the 2 live-subject rating validation sessions was substantial (mean weighted kappa = 0.78). Interrater agreement was substantial during the second rating session (0.73, primary end point).
Conclusion:
The Allergan Transverse Neck Lines Scale is a validated and reliable scale for rating of severity of neck lines.
