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Abstract
PurposeTo translate and culturally adapt the Patient and Observer Scar Assessment Scale, POSAS, to Norwegian and explore its test-retest, intra- and inter-tester reliability. MethodsPOSAS was translated into Norwegian following international guidelines in collaboration with an international translation bureau. Twenty-six adults and 24 children were recruited from a burns outpatient clinic. Three observer-categories: doctor, nurse and physiotherapist, assessed the patients’ scars and scored the Observer scale for estimating inter-tester reliability. Photos of the scars were taken and used to score the Observer scale a second time for examining intra-tester reliability. The patients or parents/next of kin rated their scar on the Patient scale at the clinic and after two days at home for examining test-retest reliability. Intraclass correlation (ICC) and Kappa were used for statistical analysis. ResultsA Norwegian version of POSAS (POSAS-NV) was developed. Inter-tester ICC of the Observer parameters varied between 0.203 and 0.728, and for the total sum score, ICC=0.528 (0.280–0.708). Intra-tester ICC of the Observer scale ranged between 0.575 and 0.858. The Patient scale demonstrated high test–retest reliability. ConclusionsIntra-tester reliability of the Observer scale and test–retest reliability of the Patient scale of POSAS-NV were found satisfactory, but not inter-tester reliability of the Observer scale.
Highlights
Evaluation of burn scars benefits from a measurement tool that reflects the quality and appearance of the scar
Category items are available and used to define: Colour, Pigmentation, Thickness, Smoothness, Elasticity, and Distribution, which are considered clinically relevant for comprehensive evaluation
When consensus was reached on a joint Norwegian version of the scale, the developers of Patient and Observer Scar Assessment Scale (POSAS) informed that they, by mistake, had given permission to a Swedish translation bureau (Facit), to translate POSAS into Norwegian
Summary
Evaluation of burn scars benefits from a measurement tool that reflects the quality and appearance of the scar. Draaijers et al developed the Patient and Observer Scar Assessment Scale (POSAS) for this purpose [1]. The scale comprises an Observer scale (OSAS) to be scored by an expert/health professional, and a Patient scale (PSAS) to be scored by the patient. For OSAS, six characteristics, called parameters, of the scar are evaluated and scored on ordinal scales: Vascularity, Pigmentation, Thickness, Relief, Pliability and Surface area. Category items are available and used to define: Colour, Pigmentation, Thickness, Smoothness, Elasticity, and Distribution, which are considered clinically relevant for comprehensive evaluation. For PSAS, the following six items are scored: Degree of pain, Itching, and comparisons to their normal skin with regard to Colour, Stiffness, Thickness and Irregularity
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