Rating the resolving hypertrophic scar: Comparison of the Vancouver scar scale and scar volume

The increased focus of research interests and clinical documentation on out comes demands that evaluation tools provide reliable and valid data. The Va ncouver Scar Scale (VSS) was developed to provide a more objective measurem ent of burn scars; however, the validity (a test's ability to measure the p henomenon for which it was designed) of the VSS has not been tested. To exa mine the construct validity of the VSS, we compared it with scar volume, wh ich has established face validity Burn scars were evaluated monthly for a m inimum of 7 months. Three scar volume measurements were performed on each s car. In addition, 3 independent examiners completed the VSS for the same sc ar. The data generated by these 2 measurements were used to establish the f ollowing: (1) the interrater agreement estimated by interclass correlation coefficient, (2) convergence validity, (3) the sensitivity of the assessmen ts to discriminate changes in the scar over time, and (4) the prevalence of related parameters that are not currently being captured by the VSS. In an attempt to address some of the deficiencies of the VSS, we propose several modifications. We anticipate that these changes will increase the reliabil ity and validity of the VSS through an increase in the awareness that train ing in the use of this scale is required, through improvement in the qualit y of the subscales, and through the documentation of additional pertinent i nformation.