Abstract：
BACKGROUND: The Patient and Observer Scar Assessment Scale (POSAS) is frequently used to assess scar quality after burns. It is important to be aware of the minimal important change (MIC) and the minimal clinically important difference (MCID) to establish if a POSAS score represents a clinically relevant change or difference. The aim of this study is to explore the MIC and MCID of POSAS version 2.0.
METHODS: This prospective study included 127 patients with deep dermal burns that underwent split thickness skin grafting with a mean age of 44 years (range 0 - 87) and total body surface area burned of 10 % (range 0.5 - 55). POSAS data was obtained for one burn scar area at three, six, and 12 months after split skin grafting. At the second and third visits, patients rated the degree of clinical change in scar quality in comparison to the previous visit. At 12 months, they completed the POSAS for a second burn scar area and rated the degree of clinical difference between the two scar areas. Two anchor-based methods were used to determine the MIC and MCID.
RESULTS: MIC values of the patient POSAS ranged from - 0.59 to - 0.29 between three and six months and from - 0.75 to - 0.38 between six and 12 months follow-up. Both had a poor discriminatory value. MCID values ranged from - 0.39 and - 0.08, with a better discriminatory value.
CONCLUSIONS: Results suggest that patients consider minor differences (less than 0.75 on the 1-10 scale) in POSAS scores as clinically important scar quality changes. MCID values can be used to evaluate the effects of burn treatment and perform sample-size calculations.
METHODS: This prospective study included 127 patients with deep dermal burns that underwent split thickness skin grafting with a mean age of 44 years (range 0 - 87) and total body surface area burned of 10 % (range 0.5 - 55). POSAS data was obtained for one burn scar area at three, six, and 12 months after split skin grafting. At the second and third visits, patients rated the degree of clinical change in scar quality in comparison to the previous visit. At 12 months, they completed the POSAS for a second burn scar area and rated the degree of clinical difference between the two scar areas. Two anchor-based methods were used to determine the MIC and MCID.
RESULTS: MIC values of the patient POSAS ranged from - 0.59 to - 0.29 between three and six months and from - 0.75 to - 0.38 between six and 12 months follow-up. Both had a poor discriminatory value. MCID values ranged from - 0.39 and - 0.08, with a better discriminatory value.
CONCLUSIONS: Results suggest that patients consider minor differences (less than 0.75 on the 1-10 scale) in POSAS scores as clinically important scar quality changes. MCID values can be used to evaluate the effects of burn treatment and perform sample-size calculations.
摘要：
背景：患者和观察者疤痕评估量表（POSAS）经常用于评估烧伤后的疤痕质量。重要的是要意识到最小重要变化(MIC)和最小临床重要差异(MCID),以确定POSAS评分是否代表临床相关变化或差异。本研究的目的是探索POSAS2.0版的MIC和MCID。
方法：这项前瞻性研究纳入了127例深度皮肤烧伤患者，这些患者接受了厚薄皮移植，平均年龄为44岁（0-87），全身表面积烧伤为10%（0.5-55）。获得了一个烧伤疤痕区域的POSAS数据，六,裂片植皮后12个月。在第二次和第三次访问中，与之前的访视相比,患者对瘢痕质量的临床变化程度进行了评分.12个月时,他们完成了第二次烧伤瘢痕区域的POSAS,并对两个瘢痕区域之间的临床差异程度进行了评级.使用两种基于锚的方法来确定MIC和MCID。
结果：患者POSAS的MIC值在3至6个月之间为-0.59至-0.29，在6至12个月之间为-0.75至-0.38。两者都具有较差的歧视性价值。MCID值范围为-0.39和-0.08，具有更好的判别值。
结论：结果表明，患者认为POSAS评分的微小差异（1-10量表小于0.75）是临床上重要的瘢痕质量变化。MCID值可用于评估烧伤治疗的效果并进行样本量计算。
方法：这项前瞻性研究纳入了127例深度皮肤烧伤患者，这些患者接受了厚薄皮移植，平均年龄为44岁（0-87），全身表面积烧伤为10%（0.5-55）。获得了一个烧伤疤痕区域的POSAS数据，六,裂片植皮后12个月。在第二次和第三次访问中，与之前的访视相比,患者对瘢痕质量的临床变化程度进行了评分.12个月时,他们完成了第二次烧伤瘢痕区域的POSAS,并对两个瘢痕区域之间的临床差异程度进行了评级.使用两种基于锚的方法来确定MIC和MCID。
结果：患者POSAS的MIC值在3至6个月之间为-0.59至-0.29，在6至12个月之间为-0.75至-0.38。两者都具有较差的歧视性价值。MCID值范围为-0.39和-0.08，具有更好的判别值。
结论：结果表明，患者认为POSAS评分的微小差异（1-10量表小于0.75）是临床上重要的瘢痕质量变化。MCID值可用于评估烧伤治疗的效果并进行样本量计算。
