Development and Validation of a Photonumeric Scale for Assessment of Chin Retrusion.
BACKGROUND
A validated scale is needed for objective and reproducible comparisons of chin appearance before and after chin augmentation in practice and clinical studies.


OBJECTIVE
To describe the development and validation of the 5-point photonumeric Allergan Chin Retrusion Scale.


METHODS
The Allergan Chin Retrusion Scale was developed to include an assessment guide, verbal descriptors, morphed images, and real subject images for each scale grade. The clinical significance of a 1-point score difference was evaluated in a review of multiple 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 difference of ≥1 point on the scale was shown to reflect a clinically meaningful difference (mean [95% confidence interval] absolute score difference, 1.07 [0.94-1.20] for clinically different image pairs and 0.51 [0.39-0.63] for not clinically different pairs). Intrarater agreement between the 2 live-subject validation sessions was substantial (mean weighted kappa = 0.79). Interrater agreement was substantial during the second rating session (0.68, primary end point).


CONCLUSIONS
The Allergan Chin Retrusion Scale is a validated and reliable scale for physician rating of severity of chin retrusion.
*Department of Otolaryngology/Facial Plastic Surgery, UC Davis Medical Group, Sacramento, California; †Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; ‡Allergan plc, Irvine, California; §Division of Dermatology, University of California at Los Angeles, Los Angeles, California; ‖Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada; ¶Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut; #Peloton Advantage, LLC, Parsippany, New Jersey.
Jonathan M
JM
Sykes
Alastair
A
Carruthers
Bhushan
B
Hardas
Diane K
DK
Murphy
Derek
D
Jones
Jean
J
Carruthers
Lisa
L
Donofrio
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*; D002680:Chin / Q000002:abnormalities* / Q000033:anatomy & histology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010781:Photography; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D055815:Young Adult
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