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Reliability of the Patient and Observer Scar Assessment Scale in Evaluating Linear Scars after Thyroidectomy
Jae-Ho Chung1, Sang-Ho Kwon, Ki-Jae Kim
1In the Department of Plastic and Reconstructive Surgery, Korea University Hospital, Seoul, Republic of Korea, Jae-Ho Chung, MD, PhD, is Clinical Assistant Professor; Sang-Ho Kwon, MD, is a resident; Ki-Jae Kim, MD, MS, is a resident; Jae-Min Lee, MD, MS, is a resident; Jeong-Min Yoon, MD, MS, is Public Health Physician; Jeong-Hyun Cheon, MD, MS, is Clinical Instructor; Eul-Sik Yoon, MD, PhD, is Professor; Seung-Ha Park, MD, PhD, MBA, is Professor. The authors have disclosed no financial relationships related to this article. Submitted October 19, 2020; accepted in revised form December 4, 2020.
Objective:
To compare the reliability of the Patient and Observer Scar Assessment Scale (POSAS) with the Vancouver Scar Scale (VSS) in evaluating thyroidectomy scars.
Methods:
At 6 months after the operation, 112 patients who underwent thyroid surgery via collar neck incision were evaluated by two blinded plastic surgeons and two senior residents using the VSS and the observer component of the POSAS. In addition, the observer-reported VAS score and patient-reported Likert score were evaluated. Internal consistency, interobserver reliability, and correlations between the patient- and observer-reported outcomes were examined.
Results:
The observer component of POSAS scores demonstrated higher internal consistency and interobserver reliability than the VSS. However, the correlations between the observer-reported VAS score and the patient-reported Likert score (0.450) and between the total sum of patient and observer component scores (0.551) were low to moderate.
Conclusions:
The POSAS is more consistent over repeated measurements; accordingly, it may be considered a more objective and reliable scar assessment tool than the VSS. However, a clinician's perspective may not exactly match the patient's perception of the same scar.
