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.
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