Agreement of Clinician‐Administered and Modified Parent‐Administered House‐Brackmann Scales in Children with Bell's Palsy. Issue 1 (24th March 2023) - Babl, Franz E.
Abstract: Objective: Currently there is no parent administered scale for facial nerve function in children. We set out to assess the agreement between a newly developed parent‐administered modified version of the House‐Brackmann (HB) scale and the standard clinician‐administered HB scale in children with Bell's palsy. Study Design: Secondary analysis of a triple‐blind, randomized, placebo‐controlled trial of corticosteroids to treat idiopathic facial paralysis (Bell's palsy) in children (6 months to <18 years). Setting: Multicenter study at pediatric hospitals with recruitment in emergency departments. Methods: Children were recruited within 72 hours of symptom onset and assessed using the clinician‐administered and the parent‐administered modified HB scales at baseline, and at 1, 3, and 6 months until recovered. Agreement between the 2 scales was assessed using intraclass coefficient (ICC) and a Bland‐Altman plot. Results: Data were available for 174 of the 187 children randomized from at least 1 study time point. The mean ICC between clinician and parent HB scores across all time points was 0.88 (95% confidence interval, CI: 0.86, 0.90). The ICC for the data collected at baseline was 0.53 (95% CI: 0.43, 0.64), at 1 month was 0.88 (95% CI: 0.84, 0.91), at 3 months was 0.80 (95% CI: 0.71, 0.87) and at 6 months was 0.73 (95% CI: 0.47, 0.89). A Bland‐Altman plot indicated a mean difference between the 2 scores (clinician‐reported minus parent‐reported) of only −0.07 (95% limits of agreement −1.37 to 1.23). Conclusion: There was good agreement between the modified parent‐administered and the clinician‐administered HB scales.