ABSTRACT NUMBER: ESOC2026A1952 UNDERSTANDING WHAT WE SHOULD MEASURE IN FACIAL PALSY AFTER STROKE AND HOW TO MEASURE IT: TOWARDS A CORE OUTCOME SET FOR POST-STROKE FACIAL PALSY

Abstract Background and aims Health professionals previously identified three outcome domains for a Core Outcome Set (COS) for post-stroke facial palsy for research and clinical practice: 1) facial movement and sensation, 2) everyday functions, and 3) living with facial palsy. We aim to examine what measurement instruments existed, their quality of evidence and their fit to the COS domains. Methods We systematically searched key electronic databases from the earliest date to October 2025. Measurement instruments, psychometric data and clinical utility were examined. We used a matrix to map instruments to COS domains, considering evidence quality. Results Evidence quality was generally low to moderate, very low or unknown. Only two clinician-rated scales had psychometric evaluation in post-stroke facial palsy: the Sunnybrook Facial Grading Scale (SFGS) and House-Brackmann Grading System (HBGS), with low-to-moderate and very-low quality evidence, respectively. These two could be used for facial movement and sensation, but do not measure everyday functions or living with facial palsy. Clinically, both scales require brief training, single-clinician administration, take a few minutes, need no special equipment, and are free to use. Conclusions SFGS and HBGS have limited psychometric evidence but could still be used to measure some elements of this core outcome set; however, further validation is needed in stroke. Currently, there is a need for suitable measurement instruments to cover everyday functions and the psychological impact of living with facial palsy. As we develop this work further with lived-experience stakeholders, we will consider what other measurement instruments are needed. Conflict of interest Havva Sumeyye Eroglu: nothing to disclose, Audrey Bowen: nothing to disclose, Matthew Checketts: nothing to disclose, Claire Mitchell: nothing to disclose