title: Measuring the severity of infantile hemangiomas: instrument development and reliability.
abstract: OBJECTIVE
  To develop instruments that measure the severity of infantile hemangiomas (Hemangioma Severity Scale [HSS]) and the complications of infantile hemangiomas for longitudinal use (Hemangioma Dynamic Complication Scale [HDCS]).
  
  
  METHODS
  Instrument development and reliability study.
  
  
  METHODS
  Academic research.
  
  
  METHODS
  The HSS and the HDCS were developed through the collaborative effort of members of the Hemangioma Investigator Group Research Core, an expert multi-institutional research group. After development of the scales, 13 pediatric dermatologists used the HSS to score 20 different hemangiomas. In addition, 12 pediatric dermatologists used the HDCS to score hemangioma-related complications for 24 clinical scenarios. Interrater and intrarater reliability was measured for both scales.
  
  
  METHODS
  Interrater and intrarater reliability.
  
  
  RESULTS
  For the HSS, interrater reliability and intrarater reliability exceeded 99%. Similarly, the HDCS had a high rate of interrater agreement; for individual items, agreement among raters was 67% to 100%, with most clinical scenarios demonstrating greater than 90% agreement. Intrarater reliability was excellent for all individual items of the HDCS.
  
  
  CONCLUSIONS
  The HSS and the HDCS are reliable scales that can be used to measure the severity of infantile hemangiomas, including the severity of complications for longitudinal use.
authors.affiliation: Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
authors.forename: Anita N
authors.initials: AN
authors.lastname: Haggstrom
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Beaumont
authors.forename: Jin-She
authors.initials: JS
authors.lastname: Lai
authors.forename: Denise M
authors.initials: DM
authors.lastname: Adams
authors.forename: Beth A
authors.initials: BA
authors.lastname: Drolet
authors.forename: Ilona J
authors.initials: IJ
authors.lastname: Frieden
authors.forename: Maria C
authors.initials: MC
authors.lastname: Garzon
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Holland
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Horii
authors.forename: Anne W
authors.initials: AW
authors.lastname: Lucky
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Mancini
authors.forename: Denise W
authors.initials: DW
authors.lastname: Metry
authors.forename: Kimberly D
authors.initials: KD
authors.lastname: Morel
authors.forename: Brandon D
authors.initials: BD
authors.lastname: Newell
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Nopper
authors.forename: Dawn
authors.initials: D
authors.lastname: Siegel
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Swigonski
authors.forename: David
authors.initials: D
authors.lastname: Cella
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Chamlin
mesh_terms: D003880:Dermatology; D006391:Hemangioma / Q000150:complications* / Q000473:pathology*; D006801:Humans; D007223:Infant; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000150:complications* / Q000473:pathology*