title: Rapid simultaneous comparison system for subjective grading scales grading scales for facial paralysis.
abstract: OBJECTIVE
  The senior authors developed a computer-assisted rapid, simultaneous comparison system for nine international grading scales for facial paralysis. The purpose of this study is to present the system and to compare the agreement of hand-performed House-Brackmann and Sunnybrook scales, two frequently used scales herein taken as the concurrent criterion test standards, with those like scales done simultaneously in the computed system.
  
  
  METHODS
  The study design was a prospective concurrent criterion validity study. Test-retest reliability and interobserver agreement were assessed using the kappa statistic (k) for ordinal data and the intraclass correlation coefficient (ICC) for semidimensional data.
  
  
  METHODS
  The study was conducted at a university practice.
  
  
  METHODS
  Ten consecutive consenting subjects with varying degrees of facial paralysis were studied.
  
  
  METHODS
  Each subject was measured, in random order, twice by each method by each of two independent observers.
  
  
  METHODS
  House-Brackmann score, Sunnybrook score, and like-scale scores done simultaneously in the computed system were measured.
  
  
  RESULTS
  Agreement between the computed system and hand-performed criterion standards was equal to each scale compared against itself; for the House-Brackmann, agreement was moderate (k = 0.554); for the Sunnybrook, agreement was excellent (ICC = 0.976).
  
  
  CONCLUSIONS
  The computed system has the advantage of allowing an examiner to view a rapid, simultaneous display of multiple grading scale scores at a keystroke from one clinical assessment input, obviating the labor of repeating measures by hand.
authors.affiliation: Department of Otolaryngology--Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110, USA.
authors.forename: A
authors.initials: A
authors.lastname: Ahrens
authors.forename: D
authors.initials: D
authors.lastname: Skarada
authors.forename: M
authors.initials: M
authors.lastname: Wallace
authors.forename: J Y
authors.initials: JY
authors.lastname: Cheung
authors.forename: J G
authors.initials: JG
authors.lastname: Neely
mesh_terms: D000328:Adult; D000368:Aged; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005149:Facial Expression; D005158:Facial Paralysis / Q000145:classification* / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014743:Videotape Recording / Q000379:methods*