Development and Validation of a Photonumeric Scale for Evaluation of Volume Deficit of the Temple.
BACKGROUND
A validated scale is needed for objective and reproducible comparisons of temple appearance before and after aesthetic treatment in practice and clinical studies.


OBJECTIVE
To describe the development and validation of the 5-point photonumeric Allergan Temple Hollowing Scale.


METHODS
The scale was developed to include an assessment guide, verbal descriptors, morphed images, and real subject images for each grade. The clinical significance of a 1-point score difference was evaluated in a review of image pairs representing varying differences in severity. Interrater and intrarater reliability was evaluated in a live-subject validation study (N = 298) completed during 2 sessions occurring 3 weeks apart.


RESULTS
A score difference of ≥1 point was shown to reflect a clinically significant difference (mean [95% confidence interval] absolute score difference, 1.1 [0.94-1.26] for clinically different image pairs and 0.67 [0.51-0.83] for not clinically different pairs). Intrarater agreement between the 2 validation sessions was almost perfect (mean weighted kappa = 0.86). Interrater agreement was almost perfect during the second session (0.81, primary endpoint).


CONCLUSIONS
The Allergan Temple Hollowing Scale is a validated and reliable scale for physician rating of temple volume deficit.
*Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada; †Division of Dermatology, University of California at Los Angeles, Los Angeles, California; ‡Allergan plc, Irvine, California; §Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut; ‖UC Davis Medical Group, Sacramento, California; ¶Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; #Peloton Advantage, LLC, Parsippany, New Jersey.
Jean
J
Carruthers
Derek
D
Jones
Bhushan
B
Hardas
Diane K
DK
Murphy
Lisa
L
Donofrio
Jonathan M
JM
Sykes
Alastair
A
Carruthers
Lela
L
Creutz
Ann
A
Marx
Sara
S
Dill
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001837:Body Weights and Measures / Q000379:methods*; D005145:Face / Q000033:anatomy & histology / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009929:Organ Size; D010781:Photography; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013100:Sphenoid Bone; D013701:Temporal Bone; D055815:Young Adult
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