Reliability of the Patient and Observer Scar Assessment Scale in Evaluating Linear Scars after Thyroidectomy

Abstract

OBJECTIVE To compare the reliability of the Patient and Observer Scar Assessment Scale (POSAS) with the Vancouver Scar Scale (VSS) in evaluating thyroidectomy scars. METHODS At 6 months after the operation, 112 patients who underwent thyroid surgery via collar neck incision were evaluated by two blinded plastic surgeons and two senior residents using the VSS and the observer component of the POSAS. In addition, the observer-reported VAS score and patient-reported Likert score were evaluated. Internal consistency, interobserver reliability, and correlations between the patient- and observer-reported outcomes were examined. RESULTS The observer component of POSAS scores demonstrated higher internal consistency and interobserver reliability than the VSS. However, the correlations between the observer-reported VAS score and the patient-reported Likert score (0.450) and between the total sum of patient and observer component scores (0.551) were low to moderate. CONCLUSIONS The POSAS is more consistent over repeated measurements; accordingly, it may be considered a more objective and reliable scar assessment tool than the VSS. However, a clinician’s perspective may not exactly match the patient’s perception of the same scar.

Analysis of trends and status of evaluation methods in thyroid scar

“…Among the 35 studies [ 2 , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] ], 15 (42.8 %) were published between 2008 and 2015. Most studies were conducted in Asia (n = 22; 62.9 %), followed by Europe (n = 10; 28.6 %) and North America (n = 3; 8.6 %).…”

“…The advantages and disadvantages of each scar evaluation method have been investigated in previous studies. However, a widely accepted measurement tool is still lacking for cosmetic outcomes [ 4 ].…”

Comparison of health‐related quality of life and cosmetic outcome between traditional gasless trans‐axillary endoscopic thyroidectomy and modified gasless trans‐axillary endoscopic thyroidectomy for patients with papillary thyroid microcarcinoma

“…The scar of patients was assessed 6 months after surgery using the POSAS 26,27 . This scale consists of a patient part and an observer part.…”

Evaluating skin colour diversity in the validation of scar assessment tools

“…This fault is also present with the Manchester Scar Scale (MSS) and Hamilton Scale, both developed in 1998 4 . In 2004, the Patient and Observer Scar Assessment Scale (POSAS) was developed as the first scar scale to incorporate both the patient and provider perspectives, making the scale more reliable when compared to the original VSS 5 . Still, this scale ignored the functional deficit and psychological impact the scar posed to the patient 6 .…”

“…4 In 2004, the Patient and Observer Scar Assessment Scale (POSAS) was developed as the first scar scale to incorporate both the patient and provider perspectives, making the scale more reliable when compared to the original VSS. 5 Still, this scale ignored the functional deficit and psychological impact the scar posed to the patient. 6 In 2018, the psychological impact of scars was incorporated into a new scar assessment scale, the Scar Q, along with other standard metrics found in previous scales that had been developed like scar appearance and scar symptoms.…”