BACKGROUND: The scientific integrity of outcome measurements is dependent upon reproducibility and accuracy. In acne assessments, there is no current gold standard for accuracy in lesion counting and global grading. PURPOSE: The purpose of this study was to create facial acne replicas for use in acne training and for evaluation of rater accuracy. METHODS: Two full-sized, three-dimensional, silicone-based, facial replicas with predetermined acne lesion type and number were created. Their teaching value was evaluated by dermatologists and clinical coordinators undergoing training in acne evaluations. A questionnaire after the training session addressed realism, preferences, and ease of assessments with the facial replicas compared to live subjects. RESULTS: Of 55 potential respondents, 32 questionnaires were completed and analyzable. Of these, 23 were from dermatologists and nine were from clinical research coordinators performing acne assessments. The facial replicas were considered sufficiently realistic for acne lesion counting by 91 percent (29/32) and for global grading by 94 percent (30/32). Of these, 66 percent preferred to have both real subjects and replicas for training (21/32), 31 percent preferred real subjects only (9/32), and one preferred replicas only. Replicas were considered easier to evaluate for noninflammatory and inflammatory lesions (p=0.002 and p=0.013, respectively) and equivalent to live models for global grading (p=0.001). LIMITATIONS: Shortcomings include the limited spectrum of acne that could be represented due to production of only two prototypes, the relative paucity of secondary lesions, and production time and cost. CONCLUSION: These facial replicas provide a realistic and practical method for teaching and evaluating raters in acne outcome measures as they provide a gold standard for acne lesion counts. Furthermore, their use may obviate some of the shortcomings inherent in recruitment of human acne volunteers for acne training sessions.
BACKGROUND: The scientific integrity of outcome measurements is dependent upon reproducibility and accuracy. In acne assessments, there is no current gold standard for accuracy in lesion counting and global grading. PURPOSE: The purpose of this study was to create facial acne replicas for use in acne training and for evaluation of rater accuracy. METHODS: Two full-sized, three-dimensional, silicone-based, facial replicas with predetermined acne lesion type and number were created. Their teaching value was evaluated by dermatologists and clinical coordinators undergoing training in acne evaluations. A questionnaire after the training session addressed realism, preferences, and ease of assessments with the facial replicas compared to live subjects. RESULTS: Of 55 potential respondents, 32 questionnaires were completed and analyzable. Of these, 23 were from dermatologists and nine were from clinical research coordinators performing acne assessments. The facial replicas were considered sufficiently realistic for acne lesion counting by 91 percent (29/32) and for global grading by 94 percent (30/32). Of these, 66 percent preferred to have both real subjects and replicas for training (21/32), 31 percent preferred real subjects only (9/32), and one preferred replicas only. Replicas were considered easier to evaluate for noninflammatory and inflammatory lesions (p=0.002 and p=0.013, respectively) and equivalent to live models for global grading (p=0.001). LIMITATIONS: Shortcomings include the limited spectrum of acne that could be represented due to production of only two prototypes, the relative paucity of secondary lesions, and production time and cost. CONCLUSION: These facial replicas provide a realistic and practical method for teaching and evaluating raters in acne outcome measures as they provide a gold standard for acne lesion counts. Furthermore, their use may obviate some of the shortcomings inherent in recruitment of human acne volunteers for acne training sessions.