Measuring the severity of infantile hemangiomas: instrument development and reliability

Arch Dermatol. 2012 Feb;148(2):197-202. doi: 10.1001/archdermatol.2011.926.

Abstract

Objectives: To develop instruments that measure the severity of infantile hemangiomas (Hemangioma Severity Scale [HSS]) and the complications of infantile hemangiomas for longitudinal use (Hemangioma Dynamic Complication Scale [HDCS]).

Design: Instrument development and reliability study.

Setting: Academic research.

Participants: The HSS and the HDCS were developed through the collaborative effort of members of the Hemangioma Investigator Group Research Core, an expert multi-institutional research group. After development of the scales, 13 pediatric dermatologists used the HSS to score 20 different hemangiomas. In addition, 12 pediatric dermatologists used the HDCS to score hemangioma-related complications for 24 clinical scenarios. Interrater and intrarater reliability was measured for both scales.

Main outcome measures: Interrater and intrarater reliability.

Results: For the HSS, interrater reliability and intrarater reliability exceeded 99%. Similarly, the HDCS had a high rate of interrater agreement; for individual items, agreement among raters was 67% to 100%, with most clinical scenarios demonstrating greater than 90% agreement. Intrarater reliability was excellent for all individual items of the HDCS.

Conclusion: The HSS and the HDCS are reliable scales that can be used to measure the severity of infantile hemangiomas, including the severity of complications for longitudinal use.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Dermatology
  • Hemangioma / complications*
  • Hemangioma / pathology*
  • Humans
  • Infant
  • Observer Variation
  • Reproducibility of Results
  • Severity of Illness Index*
  • Skin Neoplasms / complications*
  • Skin Neoplasms / pathology*