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eFACE grading system demonstrates high agreement between in-person, video assessment
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The eFACE facial grading system demonstrated strong agreement between in-person and video recording assessment as well as high test-retest reliability scores, according to study results published in JAMA Facial Plastic Surgery.
Researchers from the division of facial plastic and reconstructive surgery at the Massachusetts Eye and Ear Infirmary assessed 75 patients with varying duration and severity of unilateral facial palsy between July 1 and Dec. 31, 2014. Four static facial parameters, seven dynamic facial movements and four synkinesis parameters were assessed. There were 30 men and 45 women with a mean age of 48 years.
Results of the initial in-person and video assessment showed high agreement with the static subset having an intraclass correlation coefficient (ICC) of 0.85 (95% CI, 0.8-0.93), the dynamic subset an ICC of 0.96 (95% CI, 0.94-0.97) and the synkinesis subset an ICC of 0.9 (95% CI, 0.86-0.93). The composite ICC score was 0.94 (95% CI, 0.92-0.96).
Agreement between in-person and video assessment was excellent for 11 parameters (each demonstrating an ICC of 0.8 or higher), good for three parameters (symmetry of nasolabial fold depth at rest, nasolabial fold orientation with smile and severity of platysma synkinesis) and fair for one parameter (symmetry of the brow at rest).
The in-person interrater agreement for each subset parameters demonstrated an ICC of 0.75 or higher. The video interrater assessment maintained high agreement for nine parameters, but only good agreement for the remaining six.
Intrarater agreement remained excellent for 13 of the 15 eFACE parameters over repeat assessments. The static subset ICC was 0.93 (95% CI, 0.87-0.96), the dynamic subset ICC was 0.88 (95% CI, 0.8-0.94) and the synkinesis subset ICC was 0.92 (95% CI, 0.86-0.96). The composite ICC score was 0.96 (95% CI, 0.93-0.98).
“Excellent agreement exists between in-person and video assessments of facial mimetic function for most eFACE parameters and for all subset scores,” the researchers concluded. “Optimization of lighting conditions and verbal cues during video acquisition might further improve agreement.” – by Talitha Bennett
Disclosure: The researchers report no relevant financial disclosures.
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