Appearance scales to measure cosmetic outcomes of healed lacerations

To develop an appearance scale that will allow the objective and scientific comparison of the cosmetic results of healed lacerations, 33 photographs of healed lacerations and incisions with variable cosmetic results were shown to four plastic surgeons. These plastic surgeons were asked to independently rate the photographs on two separate occasions using two scales, a Visual Analogue Scale and a Categorical Scale. Interobserver and intraobserver agreement were determined for each scale. Comparison of the scales with each other was done to assess consistency. The Visual Analogue Scale showed good interobserver agreement with an Intraclass Correlation Coefficient of 0.75. Intraobserver agreement was also high across the four observers with Pearson correlation coefficients ranging from 0.73 to 0.87. The agreement of the categorical scale was also good with a kappa coefficient for interobserver agreement of 0.53. The kappa coefficient for intraobserver agreement ranged from 0.48 to 0.72. Because the visual analogue scale and categorical scale showed good interobserver and intraobserver agreement, both may be considered good measurement tools in the comparison of alternate methods of laceration care.