A systematic review of the quality of burn scar rating scales for clinical and research use

Tyack, Zephanie, Simons, Megan, Spinks, Anneliese and Wasiak, Jason (2012) A systematic review of the quality of burn scar rating scales for clinical and research use. Burns, 38 1: 6-18. doi:10.1016/j.burns.2011.09.021


Author Tyack, Zephanie
Simons, Megan
Spinks, Anneliese
Wasiak, Jason
Title A systematic review of the quality of burn scar rating scales for clinical and research use
Journal name Burns   Check publisher's open access policy
ISSN 0305-4179
1879-1409
Publication date 2012-02
Year available 2011
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.burns.2011.09.021
Volume 38
Issue 1
Start page 6
End page 18
Total pages 13
Place of publication Kidlington, Oxford, United Kingdom
Publisher Pergamon
Collection year 2012
Language eng
Formatted abstract
Introduction: Scar rating scales have the potential to contribute to better evaluation of scar properties in both research and clinical settings. Despite a large number of scars assessment scales being available, there is limited information regarding the clinimetric properties of many of these scales. The purpose of the review was to inform clinical and research practice by determining the quality and appropriateness of existing scales. This review summarises the available evidence for the clinimetric properties of reliability, validity (including responsiveness), interpretability and feasibility of existing scales.
Methods: Electronic searches of MEDLINE, CINAHL, EMBASE and The Cochrane Library databases from 1990 onwards were used to identify English articles related to burn scar assessment scales. Scales were critically reviewed for clinimetric properties that were reported in, but not necessarily the focus of studies.
Results: A total of 29 studies provided data for 18 different scar rating scales. Most scar rating scales assessed vascularity, pliability, height and thickness. Some scales contained additional items such as itch. Only the Patient and Observer Scar Assessment Scale (POSAS) received a high quality rating but only in the area of reliability for total scores and the subscale vascularity. The Vancouver Scar Scale (VSS) received indeterminate ratings for construct validity, reliability and responsiveness. Where evidence was available, all other criteria for the POSAS, VSS and the remaining 17 scales received an indeterminate rating due to methodological issues, or a low quality rating. Poorly defined hypotheses limited the ability to give a high quality rating to data pertaining to construct validity, responsiveness and interpretability. No scale had empirical testing of content validity and no scale was of sufficient quality to consider criterion validity.
Conclusions: The POSAS, with high quality reliability but indeterminate validity, was considered to be superior in performance based on existing evidence. The VSS had the most thorough review of clnimetrics although available data received indeterminate quality ratings. On the basis of the evidence, the use of total scores has not been supported, nor has the measurement of pigmentation using a categorical scale.
Keyword Burn scar rating measure
Burn scar assessment
Systematic review
Clinimetric quality
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 1 November 2011

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2012 Collection
School of Health and Rehabilitation Sciences Publications
School of Medicine Publications
 
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