{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T10:12:37Z","timestamp":1777543957482,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T00:00:00Z","timestamp":1698192000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clinical Trials"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/Aims<\/jats:title>\n                    <jats:p>We developed an observer disfigurement severity scale for neurofibroma-related plexiform neurofibromas to assess change in plexiform neurofibroma\u2013related disfigurement and evaluated its feasibility, reliability, and validity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-eight raters, divided into four cohorts based on neurofibromatosis type 1 familiarity and clinical experience, were shown photographs of children in a clinical trial (NCT01362803) at baseline and 1\u2009year on selumetinib treatment for plexiform neurofibromas ( n\u2009=\u200920) and of untreated participants with plexiform neurofibromas ( n\u2009=\u20094). Raters, blinded to treatment and timepoint, completed the 0\u201310 disfigurement severity score for plexiform neurofibroma on each image (0\u2009=\u2009not at all disfigured, 10\u2009=\u2009very disfigured). Raters evaluated the ease of completing the scale, and a subset repeated the procedure to assess intra-rater reliability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean baseline disfigurement severity score for plexiform neurofibroma ratings were similar for the selumetinib group (6.23) and controls (6.38). Mean paired differences between pre- and on-treatment ratings was \u22121.01 (less disfigurement) in the selumetinib group and 0.09 in the control ( p\u2009=\u20090.005). For the disfigurement severity score for plexiform neurofibroma ratings, there was moderate-to-substantial agreement within rater cohorts (weighted kappa range\u2009=\u20090.46\u20130.66) and agreement between scores of the same raters at repeat sessions ( p\u2009&gt;\u20090.05). In the selumetinib group, change in disfigurement severity score for plexiform neurofibroma ratings was moderately correlated with change in plexiform neurofibroma volume with treatment ( r\u2009=\u20090.60).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates that our observer-rated disfigurement severity score for plexiform neurofibroma was feasible, reliable, and documented improvement in disfigurement in participants with plexiform neurofibroma shrinkage. Prospective studies in larger samples are needed to validate this scale further.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17407745231206402","type":"journal-article","created":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T06:40:00Z","timestamp":1698216000000},"page":"189-198","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and pilot validation of a novel disfigurement severity scale for plexiform neurofibromas in children with neurofibromatosis type 1"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6331-0348","authenticated-orcid":false,"given":"Liny","family":"John","sequence":"first","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gurbani","family":"Singh","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Dombi","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9319-6281","authenticated-orcid":false,"given":"Pamela L","family":"Wolters","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Staci","family":"Martin","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Baldwin","sequence":"additional","affiliation":[{"name":"Clinical Research Directorate (CRD), Frederick National Laboratory for Cancer Research, Frederick, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seth M","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Biostatistics and Data Management Section, Office of the Clinical Director, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Pediatric 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