Grants We Funded

Abstract

Impact Statement: As the first population-level study of the scar experience, this study will determine reference values for the SCAR-Q, and delineate which factors influence its scores. Once established, SCAR-Q reference values will serve as the benchmark against which a patient's scar status can be compared to age- and gender-matched peers. More widespread use of the SCAR-Q will ultimately enable scar care providers to better appreciate scar concerns, collaborate with patients to choose scar treatments, and ground expectations. Given the ubiquity of scars, and the historical reliance on clinical assessment alone, the SCAR-Q as a forum for patients to articulate their experience is long overdue. Establishing its reference values then is the final substantial hurdle to amplify the scar patient's voice.

Project Summary: Every scar tells a story, and each one is different. Beyond being just a permanent skin mark, a scar can influence quality of life, impact physical functioning, and change the way a person sees themselves. Clinicians have long needed a means to account for the diverse ways that a patient is impacted by their scars. The long-term objective of our work has been to provide clinicians with a tool to incorporate the patient viewpoint, to assist in directing scar assessment and care. We developed the SCAR-Q to fulfill this need, as it was specifically designed to capture a patient's perspective. However, routine implementation of the SCAR-Q requires a contextual framework for clinicians to interpret its output. The aim of this study specifically is to develop reference values which will allow for the standardized interpretation of individual SCAR-Q scores. The SCAR-Q can be applied to any type of scar, in both adults and children, and has three scales (Appearance, Symptom, and Psychosocial Impact) – each resulting in a score out of 100. We have no indication however, which scores indicate that a patient is doing well, versus poorly; or what values would be expected in a patient with similar demographic and scar characteristics. SCAR-Q reference values would equip clinicians to better answer these questions, and ultimately appreciate their patients' scar-related health. To establish reference values, a large sample the general population is required. This cross-sectional study will aim to recruit 3,600 people with scars primarily through the social media channels of The Hospital for Sick Children, and The University of Toronto. These participants will complete the SCAR-Q, demographic questions, and other scar questions on a secure online survey platform. Anyone who is at least 8 years old, has a scar, and can access the survey is eligible to participate. We hope to capture participants of all ages, genders, education levels, socioeconomic statuses, and ethnicities, who have a scar. Ideally, their scars will be heterogenous too, with varying causes, ages, sizes, and locations on the body. From this data we will establish reference values for the SCAR-Q. We will also assess which factors, both person- and scar-related, affect SCAR-Q scores. More broadly, as the first large-scale scar study, we will learn about how people – not only patients – feel about and experience their scars.

Biography
Dr. Quong is a resident physician in the Division of Plastic and Reconstructive Surgery at The University of Toronto. She is also currently enrolled in the Surgeon Scientist Training Program and Clinician Investigator Program, and is undertaking her PhD at the Institute of Medical Science at The University of Toronto. Originally from Vancouver, she received a Bachelor of Science in Physiology and Psychology, as well as a Doctor of Medicine at The University of British Columbia. Dr. Quong has always maintained broad research interests, and has received national/international funding for projects in Vascular, Thoracic, and General Surgery. Her current thesis work focuses on patient-reported outcome measures for scarring, and the total scar experience including the psychosocial impact of having a scar. Ultimately, Dr. Quong hopes that her work will catalyze more comprehensive scar care to achieve improved patient outcomes.