A novel comprehensive scoring system for oral lichen planus: A validity, diagnostic accuracy, and clinical sensitivity study

Objectives. The objective of this study was to establish and validate a new scoring system for oral lichen planus (OLP). Study Design. Forty patients with erosive OLP were scored using a new proposed scoring system and the one suggested by Thongprasom. Statistical analysis was used to calculate inter- and intraexaminer reliability, validity, diagnostic accuracy, and clinical sensitivity for both scores. Results: Concurrent validity showed a significant strong correlation between pain scale and the new score (r(s) = 0.846) versus Thongprasom's score (r(s) = 0.665). Interexaminer agreement showed a statistically significant agreement with the biopsy results (kappa = 0.74) for the new score, whereas no agreement was evident with Thongprasom's score (kappa = 0.03163). The diagnostic accuracy of the new score was area under the curve = 0.839, whereas the diagnostic accuracy of Thongprasom's score was area under the curve = 0.667. Significant differences in the scores were detected while comparing the clinical sensitivity of both systems. Conclusions. The new comprehensive scoring system could be a valid, reproducible, and sensitive tool to accurately assess the severity of OLP. In addition, the proposed scoring system is easily taught, is relatively faster to master, and does not require complicated calculations.

Automated summary

A new scoring system for oral lichen planus (OLP) was established and validated, showing significant correlation and reliability compared to an existing system. The new system demonstrated higher diagnostic accuracy and clinical sensitivity, making it a valuable tool for assessing OLP severity.