Development and Validation of a Photonumeric Scale for Evaluation of Transverse Neck Lines.
BACKGROUND
A validated scale is needed for objective and reproducible comparisons of horizontal neck lines before and after treatment in practice and clinical studies.


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


METHODS
The Allergan Transverse Neck 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 rating validation study (N = 297) completed during 2 sessions occurring 3 weeks apart.


RESULTS
A difference of ≥1 point on the scale was shown to reflect a clinically significant difference (mean [95% confidence interval] absolute score difference, 1.22 [1.09-1.35] for clinically different image pairs and 0.57 [0.42-0.72] for not clinically different pairs). Intrarater agreement between the 2 live-subject rating validation sessions was substantial (mean weighted kappa = 0.78). Interrater agreement was substantial during the second rating session (0.73, primary end point).


CONCLUSIONS
The Allergan Transverse Neck Lines Scale is a validated and reliable scale for rating of severity of neck lines.
*Division of Dermatology, University of California at Los Angeles, Los Angeles, California; †Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; ‡Allergan plc, Irvine, California; §UC Davis Medical Group, Sacramento, California; ‖Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut; ¶Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada; #Peloton Advantage, LLC, Parsippany, New Jersey.
Derek
D
Jones
Alastair
A
Carruthers
Bhushan
B
Hardas
Diane K
DK
Murphy
Jonathan M
JM
Sykes
Lisa
L
Donofrio
Jean
J
Carruthers
Lela
L
Creutz
Ann
A
Marx
Sara
S
Dill
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D015588:Observer Variation; D010781:Photography; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*; D055815:Young Adult
Dermatol Surg. 2016 Oct;42 Suppl 1:S211-S218
27661743
J Dermatolog Treat. 2015 Jun;26(3):252-6
24953237
J Cosmet Dermatol. 2011 Jun;10(2):131-49
21649819
Dermatol Surg. 2016 Oct;42 Suppl 1:S243-S250
27661747
Facial Plast Surg. 2005 Feb;21(1):3-10
15988650
Dermatol Surg. 2016 Oct;42 Suppl 1:S195-S202
27661741
Dermatol Surg. 2015 May;41(5):623-32
25915628
J Clin Aesthet Dermatol. 2014 Aug;7(8):23-9
25161757
Dermatol Surg. 2016 Oct;42 Suppl 1:S203-S210
27661742
Stat Med. 2002 May 15;21(9):1331-5
12111881
Plast Reconstr Surg. 2014 Jan;133(1):21-30
24105086
Plast Reconstr Surg. 2008 May;121(5 Suppl):5S-30S; quiz 31S-36S
18449026
J Eur Acad Dermatol Venereol. 2010 Nov;24(11):1285-95
20569284
Psychol Bull. 1979 Mar;86(2):420-8
18839484
Dermatol Clin. 2004 Apr;22(2):159-66
15222576
Dermatol Surg. 2016 Oct;42 Suppl 1:S251-S258
27661748
Dermatol Surg. 2014 May;40(5):569-75
24689931
Facial Plast Surg Clin North Am. 2007 Feb;15(1):41-9, vi
17317554
Dermatol Surg. 2016 Oct;42 Suppl 1:S227-S234
27661745
Biometrics. 1977 Mar;33(1):159-74
843571
Dermatol Surg. 2014 Dec;40 Suppl 12:S190-3
25417574
J Drugs Dermatol. 2014 Sep;13(9):1038-46
25226003
Facial Plast Surg. 2005 Feb;21(1):65-73
15988658
Dermatol Surg. 2011 Oct;37(10):1542-5
21707832
Dermatol Surg. 2016 Oct;42 Suppl 1:S219-S226
27661744