RELIABILITY OF PHOTOGRAPHIC ANALYSIS IN DETERMINING CHANGE IN SCAR APPEARANCE

Photographs frequently are used to document change in the management o f hypertrophic scars. The purpose of this study was to design a scale for the analysis of photographs of hypertrophic scars and to test its reliability. The subjects were four occupational and physical therapis ts, (two novices and two experts), in scar management. Existing scales were modified to produce a new scale. The subjects twice rated four s lides from each often patients' scars, in random order. They used a La tin Square design. Interrater and test-retest reliabilities were calcu lated using a weighted kappa statistic. The newly developed scale demo nstrated interrater reliability, which ranged between 0.66 and 0.90 fo r all items. The test-retest reliability ranged between 0.73 and 0.89 for all items. The new scale had substantial reliability (using a sing le rater) and was at least as reliable when used by novice therapists. This indicated that training had no effect.