Sunnybrook and House-Brackmann Facial Grading Systems: intrarater repeatability and interrater agreement

Otolaryngol Head Neck Surg. 2006 Dec;135(6):865-71. doi: 10.1016/j.otohns.2006.05.748.

Abstract

Objective: To assess repeatability and agreement of the House-Brackmann (H-B FGS) and the Sunnybrook (SFGS) Facial Grading Systems.

Study design and setting: Eight video-recorded facial palsy patients were graded in 2 sittings by 28 doctors. Repeatability and agreement for SFGS were measured by intraclass correlation coefficient (ICC) and coefficient of repeatability (CR), and for H-B FGS by agreement percentage and kappa coefficients.

Results: Repeatability for SFGS was from good to excellent and for H-B FGS from fair to good. Agreement between doctors for SFGS was moderate by CR and nearly perfect by ICC. For H-B FGS, the agreement percentage was 50%, and generalized kappa indicated only fair agreement.

Conclusions: SFGS was at least as good in repeatability as H-B FGS and showed more reliable results in agreement between doctors.

Significance: While waiting for an ideal scale for facial grading, the usage of SFGS can be encouraged over H-B FGS.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Bell Palsy / classification
  • Bell Palsy / physiopathology
  • Facial Expression
  • Facial Paralysis / classification*
  • Facial Paralysis / physiopathology
  • Humans
  • Internship and Residency
  • Medical Staff, Hospital
  • Observer Variation*
  • Otolaryngology
  • Reproducibility of Results
  • Severity of Illness Index
  • Video Recording