Evaluation of essential clinical components and features of current acne global grading scales

J Am Acad Dermatol. 2013 Nov;69(5):754-761. doi: 10.1016/j.jaad.2013.07.029. Epub 2013 Aug 21.


Background: Acne research is hindered by the absence of a universal, consistently applied standard for severity grading. Acne experts recently identified 4 essential clinical components and 2 features for an ideal acne global grading scale (AGGS).

Objective: This study evaluated current AGGSs against consensus criteria previously identified as necessary.

Methods: AGGSs were identified by systematic literature search and then evaluated independently by 4 raters against criteria (components and subcomponents; features and subfeatures) identified as essential.

Results: Eighteen AGGSs fulfilled selection criteria. Three scored 1 full SD above the mean for categorical scores. We also identified highest-ranked AGGSs for subcategory scores.

Limitations: Only English-language scales were selected. Efficiency and acceptance were not evaluable.

Conclusion: Although no singular scale fulfilled all essential criteria, this study did identify highly ranked AGGSs. Incorporation and rationalization of their components and features should facilitate development of an ideal standard.

Keywords: AGGS; AGREE; Appraisal of Guidelines Research and Evaluation; CAT; FDA; Food and Drug Administration; acne; acne global grading scale; components; criteria assessment tool; essential; evaluation; features; global; grading; scales.

Publication types

  • Review

MeSH terms

  • Acne Vulgaris / pathology*
  • Humans
  • Severity of Illness Index