Field-Testing the SCAR-Q, A New Patient-Reported Outcome Measure for Scars
Bibliographic record
Abstract
Millions of scars are formed each year from surgery, trauma, and burns. Scars are known to increase anxiety in traumatic scars, impair physical functioning in burn contractures, and impact health-related quality of life in individuals with facial scars. However, until this time, a comprehensive review examining the psychosocial and quality of life impact has not been conducted across all scar etiologies. A scoping review found that scars of all etiologies have a negative psychosocial and quality of life impact regardless of etiology. Second, a new patient-reported outcome measure, the SCAR-Q, was developed and field-tested. 773 individuals were consented and 731 patients completed the SCAR-Q from the ages of 8 to 88 years representing 354 surgical, 199 traumatic, and 184 burn scars in seven centers in four countries. The analysis resulted in refinement of the Appearance, Symptoms, and Psychosocial Impact scales. Differential item functioning by age, gender, country, and scar etiologies supported using a common scoring algorithm for each scale and for international use. In addition, not only are scar ubiquitous but there has been a subsequent rise in the number of scar revisions performed. A multivariable logistic regression analysis found the perception of scarring badly and having a bothersome scar were independent risk factors for low SCAR-Q scores and for reporting the need for future scar revision surgeries. This study lays the groundwork for the use of the SCAR-Q in children and adults internationally for clinical use, research trials, and quality improvement initiatives. In addition, evidence of the negative psychosocial and quality of life impact of scars on the individual suggests that individuals with scars may require additional health resources to aid in coping. Finally, those who perceive themselves as being poor healers and have a bothersome scar have an increased risk of reporting low SCAR-Q scores and revision surgery. This information provides the clinician with a better understanding of which patients are at highest risk of having appearance-related concerns, suffer from scar-related symptomatology, or experience a negative psychosocial impact as related to their scar.
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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 | 0.009 | 0.020 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".