EVALUATIONS OF AESTHETIC RESULTS IN BREAST RECONSTRUCTION - AN ANALYSIS OF RELIABILITY

This study evaluated the reliability of three commonly used measures o f aesthetic outcomes of breast surgery: a four-point ordinal scale of overall aesthetics, five four-point subscales, and a visual analogue s cale. Fifty patients were randomly selected from women who underwent b reast reconstruction surgery at University of Michigan hospitals betwe en July 1989 and May 1993, Postoperative photographs of these patients were provided to three plastic surgeons, who were asked to rate the p hotographs using the three methods, The same process was repeated 4 we eks later. Intrarater and interrater reliability ranged from poor to g ood for the three methods, with the subscales showing the highest reli ability. The lowest reliability occurred for those scales with the lea st-explicit rating criteria, Without explicit criteria, raters must de velop and use their own criteria, which are likely to differ for each rater. Separating the various components of the aesthetic results of b reast surgery into different subscales helps make the rating criteria more explicit, Scales with demonstrated reliability are critical for e nsuring comparability of results across studies.