The PRS Rainbow Classification for Assessing Postbariatric Contour Deformities

Claire E. E. de Vries*, Lisa van den Berg, Valerie M. Monpellier, Maarten M. Hoogbergen, Aebele B. Mink van der Molen, Steve M. M. de Castro, Berend van der Lei

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: There is a need for a reliable classification system to grade contour deformities and to inform reimbursement of body contouring surgery after massive weight loss. We developed the PRS Rainbow Classification, which uses select photographs to provide standardized references for evaluating patient photographs, to classify contour deformities in postbariatric patients. To assess the reliability of the PRS Rainbow Classification to classify contour deformities in massive weight loss patients.

Methods: Ten independent experienced plastic surgeons, 7 experienced medical advisors of the healthcare insurance company, and 10 laypersons evaluated 50 photographs per anatomical region (arms, breast, abdomen, and medial thighs). Each participant rated the patient photographs on a scale of 1-3 in an online survey. The inter-observer and the intra-observer reliabilities were determined using intra-class correlation coefficients (ICCs). The ICC analyses were performed for each anatomical region.

Results: Inter-observer reliability was moderate to good in the body regions "arms," "abdomen," "medial thighs," with mean ICC values of 0.678 [95% confidence interval (CI), 0.591-0.768], 0.685 (95% CI, 0.599-0.773), and 0.658 (95% CI, 0.569-0.751), respectively. Inter-observer reliability was comparable within the 3 different professional groups. Intra-observer reliability (test-retest reliability) was moderate to good, with a mean overall ICC value of 0.723 (95% CI, 0.572-0.874) for all groups and all 4 body regions.

Conclusions: The moderate to good reliability found in this study validates the use of the PRS Rainbow Classification as a reproducible and reliable classification system to assess contour deformities after massive weight loss. It holds promise as a key part of instruments to classify body contour deformities and to assess reimbursement of body contouring surgery.

Original languageEnglish
Article number2874
Number of pages6
JournalPlastic and Reconstructive Surgery. Global Open
Volume8
Issue number6
Early online date24-Jun-2020
DOIs
Publication statusPublished - Jun-2020

Keywords

  • MASSIVE WEIGHT-LOSS
  • QUALITY-OF-LIFE
  • EXCESS SKIN
  • BARIATRIC SURGERY
  • GASTRIC BYPASS
  • PLASTIC-SURGERY
  • REDUNDANT SKIN
  • BODY-IMAGE
  • DESIRE
  • PANNICULECTOMY
  • ABDOMINOPLASTY
  • Arm lift
  • Thigh lift
  • fat

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