Determination of Inter-Rater Reliability in Pediatric Burn Scar Assessment Using a Modified Version of the Vancouver Scar Scale

The Vancouver Scar Scale is too subjective for our needs and is not culturally sensitive to our Aboriginal clients. The VSS was modified by developing a color scale to aid with vascularity rating. This study was designed to measure the inter-rater reliability of the modified Vancouver Scar Scale (MVSS). Three raters assessed 14 pediatric patients, resulting in a total of 32 scars. Data were analyzed using a Spearman Rank Order Correlation, intraclass correlation coefficient, and the kappa statistic. All subtests were shown to have significant (P < .05) correlations except for the pigmentation subtest. Because the pigmentation subtest has poor reliability, its inclusion in scar assessment should be questioned. Results indicate that only total scores of the MVSS should be used when determining burn scar outcomes because individual subtest scores appear to have little reliability. Further modifications to the MVSS followed by additional research with greater numbers of subjects are warranted.