Validation of the Turkish version of the Sunnybrook facial grading system

Abstract

Background/aim: To adapt the Sunnybrook facial grading system (SFGS) into Turkish and perform validation and reliability studieson the Turkish version.Materials and Methods: The original English version of the SFGS was translated into Turkish by performing a linguistic validity studybased on international standards. The evaluators comprised 6 physicians. Evaluations were performed twice independently using thevideo recordings of 65 facial palsy patients. Synchronously, the House-Brackman facial grading system (HBFGS) was filled out to displayconcurrent validity. The intraclass correlation coefficient (ICC) and Cronbach’s alpha was used for the examination of the inter- andintra-rater reliability. As another indication of reliability, the generalizability (G) was also examined.Results: The ICC for the inter-rater reliability for resting symmetry, symmetry of voluntary movement, synkinesis, and the compositescore, which are 4 components of the SFGS, were determined, respectively, as 0.822, 0.956, 0.606, and 0.957 for the first evaluation, and0.805, 0.965, 0.584, and 0.965 for the second evaluation. For the intra-rater reliability, the ICC were determined as 0.842, 0.956, 0.794,and 0.937, while the Cronbach’s alpha coefficients were determined as 0.809, 0.956, 0.792, and 0.948, respectively. The G coefficient wasdetermined as G = 0.772. For the concurrent validity, a strong correlation was found between the SFGS and HBFGS scores.Conclusion: The present study adapted the SFGS into Turkish, and demonstrated that the adapted scale was valid and reliable. TheTurkish version can be used for the evaluation of facial palsy, the follow-up of treatment efficiency, and standardization in reportingoutcomes with the international literature.