Assessment of practice efficacy by retrospective analysis of long‐term patient outcomes: A proposed method

Summary Background Regardless of changes in clinical techniques and approaches, practices may find value in self‐assessment. Objective To propose a retrospective method by which an aesthetic practice may use patient before and after photographs to assess practice efficacy among long standing patients. Methods Patients who had been with the practice and undergone various aesthetic procedures (n = 73, 59 women, age range 25‐83 years) were selected, with associated photographs before treatment and after their last intervention, covering an average period of 10.71 ± 1.32 years. Photographs were examined by 11 non‐expert graders in random order (along with duplicate photographs of 50 untreated individuals) who guessed and recorded the perceived age of each patient. The difference between the actual and estimated age was compared with that of the after picture to derive numerical values, averaged from among the 11 graders for each patient photo set, followed by statistical testing for confidence interval (CI) to group patients as high, medium, or low responders. Results Of 73 patients, 26 were graded as responders, 23 as medium, and 24 as low, meaning that average perceived aging changed little as per the non‐expert graders. Conclusion Statistical analysis of before and after photographs over time may provide physicians with a window into their performance.