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A scoring system for 3D surface images of breast reconstruction developed using the Delphi consensus process
Amy R Godden1, Simon H Wood2, Stuart E James3
1Royal Marsden Hospital, Downs Road, Sutton, Surrey, SM2 5PT, UK; Institute of Cancer Research, 15 Cotswold Road, Sutton, London, SM2 5NG, UK.
Summary
This study developed and validated an expert panel scale for breast reconstruction aesthetics using a Delphi consensus process. The new scale demonstrates good reliability and correlation with patient outcomes, aiding aesthetic evaluation.
Area of Science:
- Plastic Surgery
- Aesthetic Evaluation
- Reconstructive Surgery
Background:
- Aesthetic evaluation after breast reconstruction lacks objective measures, relying on panel assessments with inconsistent scales.
- Developing a standardized, reliable expert panel scale is crucial for consistent aesthetic outcome assessment.
Framework:
- A Delphi consensus process involving 61 surgeons was used to develop the expert panel scale.
- The scale incorporates key aesthetic elements: symmetry, volume, shape, breast mound position, and nipple position.
Implementation:
- The Delphi-derived scale was tested for intra- and inter-panellist reliability and correlation with Patient Reported Outcome Measures (PROMs).
- Results showed moderate to substantial intra-panel reliability and good inter-rater reliability for the global score.
Implications:
- The developed scale offers a reliable method for expert aesthetic evaluation in breast reconstruction, comparable to existing methods.
- Despite its strengths, logistical challenges persist, highlighting the ongoing need for objective, 3-Dimensional Surface Imaging (3D-SI) tools.
