Aw. Lucky et al., A MULTIRATER VALIDATION-STUDY TO ASSESS THE RELIABILITY OF ACNE LESION COUNTING, Journal of the American Academy of Dermatology, 35(4), 1996, pp. 559-565
Background: Despite widespread use of acne lesion counting, little has
been published on its reliability, particularly for multiple raters.
Objective: Our purpose was to assess reliability of acne lesion counti
ng with the use of a five-segment facial template. Methods: After trai
ning, 12 raters each evaluated 12 patients in randomized order, in the
morning and again in the afternoon, and recorded counts for different
types of lesions on a five-segment facial template. Results: Individu
al raters could reproduce their total lesion counts (reliability estim
ates, 0.81 to 0.97). Variability between raters was high, and overall
reliability estimated across raters was 0.61. For a subgroup of common
ly trained raters, overall reliability was higher (0.80). Conclusion:
The reliability of acne lesion counting is excellent when performed by
the same trained rater over time. The high variability between raters
appears to be reduced by standardized training. Because fewer lesions
are counted with less variation, use of a template may have contribut
ed to the high within-rater reliability.