A novel photonumeric hand grading scale for hand rejuvenation

Abstract

Background Few scales are currently available to evaluate changes in hand volume. We aimed to develop a hand grading scale for quantitative assessments of dorsal hand volume with additional consideration of changes in skin texture; to validate and prove the precision and reproducibility of the new scale; and to demonstrate the presence of clinically significant differences between grades on the scale. Methods Five experienced plastic surgeons developed the Hand Volume Rating Scale (HVRS) and rated 91 images. Another five plastic surgeons validated the scale using 50 randomly selected images. Intra- and inter-rater agreement was calculated using the weighted kappa statistic and intraclass correlation coefficients (ICCs). Paired images were also evaluated to verify whether the scale reflected clinical differences. Results The intra-rater agreement was 0.95 (95% confidence interval, 0.922–0.974). The interrater ICCs were excellent (first rating, 0.94; second rating, 0.94). Image pairs that differed by 1, 2, and 3 grades were considered to contain clinically relevant differences in 80%, 100%, and 100% of cases, respectively, while 84% of image pairs of the same grade were found not to show clinically relevant differences. This confirmed that the scale of the HVRS corresponded to clinically relevant distinctions. Conclusions The scale was proven to be precise, reproducible, and reflective of clinical differences.

A Single-Center Pilot Study to Classify Signs of Dorsal Hand Aging Using 3 Grading Scales

“… 6 Finally, Lee et al developed the Hand Volume Rating Scale (HVRS) in 2019. 9 The authors argued that in order to evaluate the outcomes of hand rejuvenation procedures, both hand volume and textural changes must be considered. Therefore, their 5-point photonumeric scale also accounts for the degree of skin roughness.…”

“… 1 In reviewing the literature, there are 3 scales currently validated for the assessment of dorsal hand aging—the Merz Hand Grading Scale (MHGS), 1 , 3 the Allergan Hand Volume Deficit Scale, 6 and the Hand Volume Rating Scale (HVRS). 9 As the names suggest, all 3 scales are limited to evaluating the volume loss. As other factors also contribute to the appearance of aged hands, such as wrinkling, textural roughness, and general dyschromia, more scales that take these additional components into account must be created.…”

Validating a Series of Photonumeric Rating Scales for Use in Facial Aesthetics Using Statistical Analysis of Intra- and Inter-rater Reliability

“…Conversely, the high ICC values indicate that the scales can be used for dependable evaluation by individual raters at different times. 18 Accordingly, high reliability scores are a primary consideration of a scale’s utility and application. 19 Additional considerations include ease of use.…”

Escalas clínicas para evaluar el envejecimiento cutáneo: una revisión de la literatura

“…15,20 Un pequeño número de escalas se limitan al cuello, 30 tórax anterior 23,31 y extremidades superiores. 17,19,25,32 La Figura 1 muestra las principales zonas evaluadas en cara por las diferentes escalas clínicas.…”

“…www.medigraphic.com/dermatologicopascua www.medigraphic.org.mx queratosis actínicas, leucodermia lenticular, pérdida de elasticidad y flacidez, púrpura y adelgazamiento de la piel). 17 Por último, las manos 19,32 son otra área extrafacial en la que los principales datos clínicos a calificar son la pérdida de volumen, la presencia de líneas muy finas, así como tendones y venas visibles.…”