Likert scale versus the visual analogue scale in evaluating dentofacial aesthetics: a systematic review

Study	Title	Outcomes
Aşik & Kök (2021)¹³	Perception of dental midline deviation and smile attractiveness by eye-tracking and aesthetic ratings	The ICC was 0.805 for the VAS, and 0.760 for the Likert Scale No statistically significant difference between the genders VAS and Likert scores were consistent with the eye-tracking data. No statistically significant difference between the age groups.
Hatch et al. (2017)¹²	Effects of objective 3D measures of facial shape and symmetry on perceptions of facial attractiveness	The test-retest reliability for overall facial attractiveness ratings was 0.69 on the Likert-scale and 0.75 on the VAS.
Dourado et al. (2021)⁸	Likert scale vs visual analog scale for assessing facial pleasantness	Intra examiner errors were 0.70 and 0.69 for the Likert scale and VAS, respectively.Good correlation was observed between both the scales.Laypeople presented the lowest correlation (moderate) among the 3 groups. 75% of the examiners preferred the Likert scale.VAS requires some time to measure.Regardless of sex, the evaluators were able to assess similarly using the 2 methods.
Eslamipour et al. (2017)¹⁴	Correlation coefficients of three self-perceived orthodontic treatment need indices	The intraclass coefficient for each examiner was over 0.9.VAS had the highest sensitivity (44.6%).VAS is an easy and understandable index for all age groups and social levels.Age and gender of the patient, and also the economic status of the family had no significant correlation with these indices.
Fudalej et al. (2017)¹⁵	Comparison of three methods of rating nasolabial appearance in cleft lip and palate	The VAS method was in turn more reproducible than Likert scale.Results imply that a 5-point esthetic index is not optimal for esthetic rating of the nasolabial region in CLP.Recommend the use of reference. photographs along with the VAS. Likert-type scales seem to produce the most variable results

Risk of bias (RoB) with STROBE checklist

	STROBE
Paper	Study	Score	Paper
Perception of dental midline deviation and smile attractiveness by eye-tracking and aesthetic ratings	Aşik & Kök (2021)¹³	78.5%	Good
Effects of objective 3D measures of facial shape and symmetry on perceptions of facial attractiveness	Hatch et al. (2017)¹²	75.3%	Good
Likert scale vs visual analog scale for assessing facial pleasantness	Dourado et al. (2021)⁸	85.18%	Excellent
Correlation coefficients of three self-perceived orthodontic treatment need indices	Eslamipour et al. (2017)¹⁴	85.18%	Excellent

Eligibility criteria

Criteria	Inclusion criteria	Exclusion criteria
Population	Laypeople and/or dental clinicians
Intervention	Likert Scale and VAS used in assessing facial aesthetic
Outcome measures	1.Validity and/or reliability of both scale2.Patient and/or clinician’s preference between Likert Scale and VAS
Study design	Randomized controlled trial, cross sectional study	Reviews, case reports, letters to editor, and all other non-peer-reviewed articles
Others	All language article

Study methodology, population, intervention characteristics, and outcome measure(s)

Study	Study Methodology	Study Population	Intervention Charateristics	Outcome Measure(s)
Fudalej et al. (2017)¹⁵	Randomized controlled trial	Eight junior orthodontic residents without any experience in treatment of CLP.Age: 25 to 31 years old (four male and four female).	Extra-oral images of 60 non-syndromic complete unilateral cleft lip and palate (CLP) patients were taken from the frontal and profile views and were cropped.Photographs (N = 60) were divided into three groups (A, B and C) equally.Afterwards, three subgroups were formed within each group (A1, A2, A3; B1, B2, B3; and C1, C2, C3). The order of images in subgroups were arranged using random numbers generated online.Images from subgroups designated 1 were rated with VAS, images from subgroups designated 2 were rated with esthetic index (5-point Likert scale), and images from subgroups designated 3 were rated with reference score which used numerical scale from 0 to 200 and a reference photograph	Reliability was measured by using intraclass correlation coefficient (ICC) in assessing nasolabial appearance.
Asik & Kök (2021)¹³	Cross-sectional	195 participants (52 laypersons, 50 patient’s - relatives, 51dentists, and 42 orthodontists) from the Necmettin Erbakan University Faculty of Dentistry, Department of Orthodontics.Gender: 102 females, 93 males Age groups: 20-30, 30-40, 40-50 and over 50 years.	Photographs of a female frontal posed smile were cropped to include only mouth and teeth produced a base image. Dental midline was adjusted 1, 2, 3, and 4mm to the left and right sides using Adobe Photoshop CC 2014 software resulting in 8 modified smile images.11images with eight modified smile photographs, one base photograph and 2 repeating photographs were randomly listed. Eye tracking device was used to detect participants’ eyes on the screen.Volunteers evaluated each image from an aesthetic point of view using survey forms consisting of VAS and Likert Scales	Effect of dental midline deviation on the perception of smile aesthetics by orthodontist, dentists, patient relatives, and layperson.Reliability of eye tracking data, VAS and Likert scale was measured using intraclass correlation coefficients (ICC).Age and gender effect towards VAS and Likert scale scores in assessing dental midline.
Hatch et al. (2017)¹²	Cross-sectional	Ten university students and staff (5 females and 5 males) identified from convenience sampling approach	Frontal and lateral views of images of 313 adults in Iowa were presented to the raters.The rates evaluated the overall facial attractiveness on a 5-point Likert scale and a VAS	Reliability of both scales by using test-retest reliability in measuring overall facial attractiveness.Correlation between Likert Scale and VAS.
Dourado et al. (2021)⁸	Cross-sectional	90 evaluators divided into 3 groups equally: Lay people (20-67 years old)Orthodontist (27-45 years old) Oral and maxillofacial surgeon (26-51 years old).	Evaluation on facial pleasantness was done on 10 adult patients’ photographs that underwent orthodontic treatment for different facial discrepancies compiled in an album.Each evaluator will assess the album at 2 different times 15-30 days apart.	Reliability of Likert scale and VAS was measured through intra examiner error analysis.Correlation between both scales was measured using the Spearman correlation coefficient.Compare preference of both scales from the perspective of orthodontist, oral maxillofacial surgeons and laypeople.
Eslamipour et al. (2017)¹⁴	Cross-sectional	993 freshman students from Isfahan University were randomly selected and examined to assess the dental health component (DHC) index of the Index of orthodontic treatment need (IOTN) Examination was done by two examiners.	Questionnaire divide into three sections: Demographic, index of oral aesthetic subjective index scale (OASIS) using 7-point Likert scale, VAS and IOTN.	Determination of most reliable self-perceived indices by using intraclass coefficients.To assess sensitivity and specificity of self-perceived indices (Aesthetic component, OASIS and VAS) in comparison to DHC as normative index in young adults.

eISSN:: 2207-7480
Język:: Angielski

Częstotliwość wydawania:: Volume Open
Dziedziny czasopisma:: Medicine, Basic Medical Science, other

Kanał RSS czasopisma

Likert scale versus the visual analogue scale in evaluating dentofacial aesthetics: a systematic review

Data publikacji: 05 cze 2024

Zakres stron: 158 - 168

Otrzymano: 01 wrz 2023

Przyjęty: 01 kwi 2024

DOI: https://doi.org/10.2478/aoj-2024-0010

© 2024 Hanis Nabilah Marzuki et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

Figure 2.

Summary of research outcomes

Risk of bias (RoB) with STROBE checklist

Eligibility criteria

Study methodology, population, intervention characteristics, and outcome measure(s)