Retrospective cohort study demonstrates strong criterion validity of Physician Global Assessment for photoaging in screening adults, indicating its utility as a rapid clinical proxy.
Key Points
To determine the reliability, criterion validity, and clinical utility of the Physician Global Assessment (PGA) as a rapid proxy for photoaging severity compared with the SCINEXA standard.
Analyzed standardized digital skin images from a retrospective cohort of 175 adults undergoing skin cancer screening in the Netherlands between 2022 and 2024.
Evaluated inter- and intra-observer reliability using 64 facial image assessments from 16 participants rated by three dermatologists.
Identified independent SCINEXA predictors of high PGA scores (≥3) using multivariable logistic regression.
High PGA scores were independently predicted by sunburn freckles (OR: 49.8; 95% CI: 2.73–909.46), cutis rhomboidalis nuchae (OR: 14.84; 95% CI: 2.28–96.64), pseudoscars (OR: 14.21; 95% CI: 1.79–113.15), and poikiloderma (OR: 6.64; 95% CI: 1.08–40.91).
A reduced prediction model containing these four features achieved an overall diagnostic accuracy of 96.0% and an area under the receiver operating characteristic curve of 0.985 (95% CI: 0.954–0.997).
PGA displayed the highest inter-observer agreement among all examined photoaging markers along with good intra-observer reproducibility.