Changes in Subjective vs Objective Burn Scar Assessment Over Time: Does the Patient Agree With What We Think?
Bibliographic record
Abstract
It is not known whether objective measurements of burn scar quality reflect, or even bear any relationship to, the patient's opinion of their scar. The purpose of this study was to determine whether any correlation exists between the rehabilitation therapist's rating of the scar using the Vancouver Scar Scale (VSS) and the patient's subjective opinion of their scar. A total of 37 scars in 20 adult patients (mean age, 34 +/- 13 years; 30% female; mean %TBSA burn, 16 +/- 11%) were evaluated at 3.1 +/- 1.9 months after injury (early assessment). Patients were asked to rate their own scar (question 1) and to rate how they perceive other people view the scar (question 2). A visual analog scale (VAS) was used to score the answers to both questions. A burn occupational therapist who was blinded to the VAS scores performed a VSS rating of the scar. These evaluations were repeated 1.5 years after injury (late assessment). At the early assessment, there was no correlation between the VSS score and VAS scores for question 1 (r =.291) or question 2 (r =.371). At the late assessment, there was significant improvement in the VSS score and the VAS score for question 2. Also, a significant correlation developed between the VSS score and the VAS score for question 1 (r =.646, P =.003) but not between the VSS score and VAS score for question 2 (r =.099). The VSS measurement of the scar bears no relationship to the patient's opinion of their scar early after a burn injury. As the scar improves over time, the patient's opinion of their scar appears to improve and shows better correlation with the VSS rating. Conversely, the patient's impression of what others think of the scar continues to bear no relationship to the VSS rating, suggesting that scar acceptance by the patient is incomplete despite objective improvement in the quality of the scar. Although the VSS was never intended to measure a patient's opinion of their scar, these preliminary findings emphasize the necessity of including a patient-centered subjective component to routine scar monitoring and assessment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.026 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".