背景:在乳房重建中,很少有经过验证的美学评估工具使用离散量表来促进与多个评估者的研究。
目的:这项研究旨在提出一种用于重建乳房的美学评估量表。
方法:建议使用离散变量,响应范围为1至10,每个类别的响应可以求和以获得平均值,该平均值可用于多个评估者的研究。为了测试本研究中建议的仪器,5名经验丰富的整形外科医生评估了46名患者。对于所有的分析,零假设的拒绝水平为5%(p<0.05)。
结果:建议量表获得有效的组内相关系数,0.9用于乳房的整体美学评估,最低为0.77用于定义乳房下褶皱。我们在所有比较中观察到良好的诊断准确性,曲线下面积为0.85~0.97。关于收敛有效性,我们观察到乳房体积和体积对称性之间的相关性为0.77(p<0.001),乳房形状和轮廓自然度之间为0.66(p<0.001)。测试-重测可靠性为0.708,这被认为是良好的。
结论:这项研究的结果支持拟议的新美学评估量表的有效性,揭示不同评估者之间以及随着时间的推移的一致性。收敛验证加强了新量表变量与Garbay量表变量之间的关系。此外,强大的诊断准确性凸显了新量表在评估乳房重建美学结果方面的临床实用性.
BACKGROUND: Few validated aesthetic assessment instruments in breast reconstruction use discrete scales to facilitate studies with multiple evaluators.
OBJECTIVE: This research aimed to propose an aesthetic assessment scale for reconstructed breasts.
METHODS: A scale was suggested using discrete variables, with responses ranging from 1 to 10, and the responses for each category could be summed to obtain an average that could be used in studies with multiple evaluators. To test the instrument suggested in this study, 5 experienced plastic surgeons assessed 46 patients. For all the analyses, a rejection level for the null hypothesis of 5% (p < 0.05) was adopted.
RESULTS: The suggested scale obtained valid intraclass correlation coefficients, with 0.9 for the overall aesthetic evaluation of the breast and the lowest being 0.77 for defining the inframammary fold. We observed good diagnostic accuracy in all comparisons, with the area under the curve ranging from 0.85 to 0.97. Regarding convergent validity, we observed correlations of 0.77 (p < 0.001) between breast volume and volume symmetry, 0.66 (p < 0.001) between breast shape and contour naturalness. The test-retest reliability was 0.708, which is considered good.
CONCLUSIONS: The results of this study support the effectiveness of the proposed new aesthetic evaluation scale, revealing consistency among different evaluators and over time. Convergent validation strengthens the relationship between the variables of the new scale and those of the Garbay scale. Furthermore, the robust diagnostic accuracy highlights the clinical utility of the new scale in assessing aesthetic outcomes in breast reconstructions.