Classification of central facial paralysis: an agreement analysis

To identify whether there is interrater and intrarater agreement in the classification of the degree of central facial paralysis using two scales and verify which one is more appropriate to classify the severity of facial expressions according to experts' opinion.

Observational, prospective, cross-sectional study of agreement analysis of the House & Brackmann (HB) scale and the Sunnybrook Facial Grading System (SFGS). Five speech-language-hearing pathologists with clinical experience analyzed post-stroke facial expression of 30 adults for interrater agreement. They were evaluated in two stages, with a 10-day interval; the second stage involved 20% ​​of the initial sample for intrarater agreement. The study used weighted kappa coefficient for the HB scale and the intraclass correlation coefficient for the SFGS classification.

The HB scale indicated considerable interrater and excellent intrarater agreements. The SFGS had good interrater and intrarater agreements. All speech-language-hearing pathologists considered the SFGS the most appropriate scale for classifying central facial paralysis.

The SFGS performed better in interrater agreement analysis. The HB scale had considerable merits in the intrarater assessment. Both scales are adaptable and useful to assess and classify central facial paralysis. However, the speech-language-hearing pathologists indicated the SFGS as the most appropriate.