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Validated Composite Assessment Scales for the Global Face

Rzany, Berthold MD, ScM1; Carruthers, Alastair MD2; Carruthers, Jean MD3; Flynn, Timothy C. MD4,5; Geister, Thorin L. PhD6; Görtelmeyer, Roman PhD6; Hardas, Bhushan MD7; Himmrich, Silvia MSc6; Jones, Derek MD8; de Maio, Maurício MD9; Mohrmann, Cornelia MD6; Narins, Rhoda S. MD10,11; Pooth, Rainer MD, PhD6; Sattler, Gerhard MD12; Buchner, Larry BA13; Merito, Monica PhD14; Fey, Constanze PhD14; Kerscher, Martina MD, PhD15

doi: 10.1111/j.1524-4725.2011.02252.x
Original Articles
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Background Twenty grading scales have been developed to assess age-related facial changes. Until now, the validity with regard to the patient's actual age and the clinical importance of combined measurement tools to describe facial aging was unclear.

Objective To investigate the reliability and validity of a total face score and three global face assessment scales for estimated age, estimated aesthetic treatment effort, and signs of aging in the facial units.

Materials and Methods Descriptive, reliability, correlation, and principal component analyses based on the assessment of 50 subjects by 12 raters using the 20 grading scales and the global face assessment scales.

Results Inter- and intrarater reliability was high for the total face score and for the scales on estimated age and aesthetic treatment effort. Actual age was highly correlated with these three measures. Facial aging was indicated particularly by scales of the lower face.

Conclusion The aesthetic grading scales and global scales on estimated age and aesthetic treatment effort are reliable and valid instruments. The results suggest that a more-comprehensive evaluation of the human face and its age-related changes can help to identify important areas of facial aging and to define optimal aesthetic treatment strategies.

1Division of Evidence Based Medicine, Klinik für Dermatologie, Charité—Universitätsmedizin Berlin, Berlin, Germany

2Dermatology and Skin Sciences,

3Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada

4Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,

5Cary Skin Center, Cary, North Carolina,

6Research and Development HQ, MERZ Pharmaceuticals GmbH, Frankfurt, Germany

7Research and Development, MERZ Pharmaceuticals LLC, Greensboro, North Carolina,

8Department of Dermatology, University of California at Los Angeles, Los Angeles, California,

9Clinica Mauricio De Maio, Sao Paolo, Sao Paolo, Brasil

10Dermatology Surgery and Laser Center New York,

11Department of Dermatology, New York University School of Medicine, New York, New York,

12Rosenparkklinik, Darmstadt, Germany

13Canfield Scientific Inc, Fairfield, New Jersey,

14INC Research GmbH, Munich, Germany

15Division of Cosmetic Sciences, University Hamburg, Hamburg, Germany

Address correspondence and reprint requests to: Berthold Rzany, MD, ScM, Division of Evidence Based Medicine, Klinik für Dermatologie, Charité—Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany, or e-mail: mail@rzany-berlin.de

Drs. Alastair Carruthers, Jean Carruthers, Derek Jones, Maurício de Maio, Rhoda.S Narins, Berthold Rzany, Martina Kerscher, Timothy C. Flynn, and Gerhard Sattler are paid consultants to Merz Pharmaceuticals.

Merz Pharmaceuticals GmbH provided funding for this study.

© 2012 by the American Society for Dermatologic Surgery, Inc.
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