Intra- and inter-observer reliability of the application of the cellulite severity scale to a Spanish female population

• Published in: Journal of the European Academy of Dermatology and Venereology 2013-06, Vol.27 (6), p.694-698
• Main Authors: De La Casa Almeida, M., Suarez Serrano, C., Jiménez Rejano, J.J., Chillón Martínez, R., Medrano Sánchez, E.M., Rebollo Roldán, J.
• Format: Article
• Language: English
• Subjects: Adipose Tissue; Adult; Female; Humans; Obesity - diagnosis; Obesity - epidemiology; Observer Variation; Severity of Illness Index; Spain; Young Adult
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1111/j.1468-3083.2012.04536.x

Background  ‘Hexsel, dal’Forno and Hexsel Cellulite Severity Scale’ (CSS) was developed to evaluate cellulite with an objective and easy to apply tool. Objective  Study CSS intra‐ and inter‐observer reliability in a Spanish female population by evaluating patients’ cellulite through photographs of their overall gluteofemoral zone as opposed to its creators who distinguished between buttocks and thigh. Methods  Cellulite Severity Scale was applied to 27 women, evaluating gluteofemoral cellulite, differentiating between left and right. Evaluations were made by three expert examiners each at three times with a 1‐week separation. Variables were the five CSS dimensions (number of evident depressions; depth of depressions; morphological appearance of skin surface alterations; grade of laxity, flaccidity, or sagging skin; and the Nürnberger and Müller classification scale), and the overall CSS score. Cronbach’s alpha, intra‐class correlation and item total correlation were analysed. Results  Cronbach’s alpha values were 0.951 (right) and 0.944 (left). In the intra‐observer reliability analysis, intra‐class correlation coefficient ranged from 0.993 to 0.999 (P