A validated grading scale for crow's feet.
OBJECTIVE
To develop the Crow's Feet Grading Scale for objective quantification of the severity of lateral canthal lines and to establish the reliability of this photonumeric scale for clinical research and practice.


METHODS
A 5-point photonumeric rating scale was developed to objectively quantify the severity of lateral canthal lines at rest and at maximum contracture of the orbicularis oculi. Nine experts rated photographs of 35 subjects, twice, with regard to the aspect crow's feet in comparison with morphed images. Inter- and intrarater variability was assessed by computing intraclass correlation coefficients.


RESULTS
The agreement between the experts was significantly high. Furthermore, the test-retest correlation coefficients were high for each expert after an overnight interval, demonstrating low inter- and intraevaluator variability.


CONCLUSIONS
The 5-point photonumeric scale generated spans the severity of the type of crow's feet for which patients most commonly seek correction. The scale is well stratified for consistent rating.
Carruthers
Alastair
A
Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada. alastair@carruthers.net
Carruthers
Jean
J
Hardas
Bhushan
B
Kaur
Mandeep
M
Goertelmeyer
Roman
R
Jones
Derek
D
Rzany
Berthold
B
Cohen
Joel
J
Kerscher
Martina
M
Flynn
Timothy Corcoran
TC
Maas
Corey
C
Sattler
Gerhard
G
Gebauer
Alexander
A
Pooth
Rainer
R
McClure
Kathleen
K
Simone-Korbel
Ulli
U
Buchner
Larry
L
D004954:Esthetics / Q000145:classification*; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D015588:Observer Variation; D010781:Photography; D015203:Reproducibility of Results; D015595:Skin Aging