Agreement of Clinician‐Administered and Modified Parent‐Administered House‐Brackmann Scales in Children with Bell's Palsy

Abstract

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.

Keywords

• Bell's palsy
• emergency department
• House‐Brackman scale
• multicenter trial