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Daniel Cassuto,1 Giovanni Pellacani,2 Antonello Tateo,1 Ofir Artzi,3 Fabio Massimo Ingallina,4 Giovanni Salti,5 Elena Rossi,2 Arturo Lanzarotti,6 Malika Laouedj,7 Nicolas Dapis,7 Gilberto Bellia8 1Private Practice, Milan, Italy; 2Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy; 3Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; 4Private Practice, Catania, Italy; 5Private Practice, Florence, Italy; 6IBSA Institut Biochimique SA, Lugano, Switzerland; 7Quantificare SA, Valbonne, France; 8IBSA Farmaceutici Italia, Lodi, ItalyCorrespondence: Gilberto BelliaIBSA Farmaceutici Italia, Lodi, ItalyEmail gilberto.bellia@ibsa.itObjective: To describe the development and validation of the 5-grade photographic IBSA inner upper arm scale.Methods: From 2 real-life pictures, a scale made up of 5 morphed images showing increasing severity of inner upper arm laxity was created. For validation, a set of 50 images (half of which real and the other morphed) was developed and sent to 5 trained physicians in two rounds 30 days apart. Raters’ task was to make a selection of each image according to the given scale. Inter-rater and intra-rater reliability were evaluated in both rounds.Results: As to intra-rater reliability, single-rater kappa scores between 0.74 and 1.00 and a global kappa score of 0.846 were observed, while inter-rater agreement was calculated with intra-class correlation coefficient reporting scores higher than 0.91, which indicate excellent reliability.Conclusion: IBSA inner upper arm laxity scale proved to be a validated and reliable tool.Keywords: photographic scale, upper inner arm, laxity, aesthetic medicine, scale validation, scale development |
