Development and Validation of a Photonumeric Scale for Evaluation of Facial Fine Lines.
BACKGROUND
A validated scale is needed for objective and reproducible comparisons of facial fine lines before and after treatment in practice and clinical studies.


OBJECTIVE
To describe the development and validation of the 5-point photonumeric Allergan Fine Lines Scale.


METHODS
The Allergan Fine Lines 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 = 289) 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% CI] absolute score difference, 1.06 [0.92-1.21] for clinically different image pairs and 0.50 [0.38-0.61] for not clinically different pairs). Intrarater agreement between the 2 live subject validation sessions was almost perfect (weighted kappa = 0.85). Interrater agreement was substantial during the second rating session (0.76, primary end point).


CONCLUSIONS
The Allergan Fine Lines Scale is a validated and reliable scale for physician rating of severity of superficial fine lines.
*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; ‡Allergan plc, Irvine, California; §Division of Dermatology, University of California, Los Angeles, Los Angeles, California; ‖Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; ¶UC Davis Medical Group, Sacramento, California; #Peloton Advantage, LLC, Parsippany, New Jersey.
Jean
J
Carruthers
Lisa
L
Donofrio
Bhushan
B
Hardas
Diane K
DK
Murphy
Derek
D
Jones
Alastair
A
Carruthers
Jonathan M
JM
Sykes
Lela
L
Creutz
Ann
A
Marx
Sara
S
Dill
D003357:Cosmetic Techniques; D004954:Esthetics; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008297:Male; D010781:Photography / Q000379:methods*; D015595:Skin Aging
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