2
|
Zhu S, Jayaraman J, Khambay B. Evaluation of Facial Appearance in Patients with Cleft Lip and Palate by Laypeople and Professionals: A Systematic Literature Review. Cleft Palate Craniofac J 2018; 53:187-96. [DOI: 10.1597/14-177] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective To identify whether laypeople and professionals rate the facial appearance of patients with cleft lip and palate (CLP) similarly based on viewing full facial images. Design Several electronic databases were searched. A hand search was performed among reference lists and relevant journals. Studies that assessed the full facial appearance of patients with CLP based on two-dimensional (2D) photographs, 3D images, or clinical examination by laypeople and professionals using a visual analog scale (VAS) or a categorical rating scale were included. Two authors independently assessed articles using methodologic-quality scoring protocol. Result Eleven articles were included in qualitative synthesis, including four high-level and seven moderate-level papers. Three studies found that laypeople were more critical than professionals, three found there was no significant difference between laypeople and professionals, and five reported that professionals were more critical than laypeople when assessing facial appearance of patients with CLP. Conclusions It still remains unknown whether laypeople are more or less critical than professionals when rating facial appearance of patients with repaired CLP. Professionals are more familiar with the esthetic outcomes and difficulties of treating patients. The opposite maybe true for laypeople; this disparity between what is achievable by professionals and what is expected by laypeople may be a source of dissatisfaction in facial appearance outcome. Further well-designed studies should be carried out to address this question and the clinical significance of the difference in rating scores for patients with CLP.
Collapse
Affiliation(s)
- Shiwen Zhu
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Jayakumar Jayaraman
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Balvinder Khambay
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| |
Collapse
|
3
|
Campbell A, Restrepo C, Deshpande G, Tredway C, Bernstein SM, Patzer R, Wendby L, Schonmeyr B. Validation of a Unilateral Cleft Lip Surgical Outcomes Evaluation Scale for Surgeons and Laypersons. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1472. [PMID: 29062644 PMCID: PMC5640349 DOI: 10.1097/gox.0000000000001472] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 07/11/2017] [Indexed: 10/31/2022]
Abstract
BACKGROUND A standardized evaluation tool is needed for the assessment of surgical outcomes in cleft lip surgery. Current scales for evaluating unilateral cleft lip/nose (UCL/N) aesthetic outcomes are limited in their reliability, ease of use, and application. The Unilateral Cleft Lip Surgical Outcomes Evaluation (UCL SOE) scale measures symmetry of 4 components and sums these for a total score. The purpose of this study was to validate the SOE as a reliable tool for use by both surgeons and laypersons. METHODS Twenty participants (9 surgeons and 12 laypeople) used the SOE to evaluate 25 sets of randomly selected presurgical and postsurgical standardized photographs of UCL/N patients. Interrater reliability for surgeon and laypeople was determined using an intraclass correlation coefficient (ICC). RESULTS Individual surgeons and laypeople both reached an ICC in the "fair to good" range (ICC = 0.42 and 0.59, respectively). Averaging 2 evaluators in the surgeon group improved the ICC to 0.58 and in the laypeople group to 0.74, respectively. Averaging 3 evaluators increased the ICC for surgeons to the "good" range (ICC = 0.71) and the ICC for laypeople to the "very good" range (ICC = 0.82). CONCLUSIONS Surgeon and layperson raters can reliably use the SOE to assess the aesthetics results after surgical repair of UCL/N, and improved reliability and reproducibility is achieved by averaging the scores of multiple reviewers.
Collapse
Affiliation(s)
- Alex Campbell
- From Operation Smile, Virginia Beach, Va.; Plastic Surgery, Penn State Hershey, Hershey, Pa.; MGM Dental College and Hospital, Navi Mumbai, India; School of Medicine, Emory University, Atlanta, Ga.; Department of Epidemiology, Emory University School of Medicine, Atlanta, Ga.; Department of Surgery, Emory University School of Medicine, Atlanta, Ga.; and Plastic Surgery, Skane University Hospital, Malmo, Sweden
| | - Carolina Restrepo
- From Operation Smile, Virginia Beach, Va.; Plastic Surgery, Penn State Hershey, Hershey, Pa.; MGM Dental College and Hospital, Navi Mumbai, India; School of Medicine, Emory University, Atlanta, Ga.; Department of Epidemiology, Emory University School of Medicine, Atlanta, Ga.; Department of Surgery, Emory University School of Medicine, Atlanta, Ga.; and Plastic Surgery, Skane University Hospital, Malmo, Sweden
| | - Gaurav Deshpande
- From Operation Smile, Virginia Beach, Va.; Plastic Surgery, Penn State Hershey, Hershey, Pa.; MGM Dental College and Hospital, Navi Mumbai, India; School of Medicine, Emory University, Atlanta, Ga.; Department of Epidemiology, Emory University School of Medicine, Atlanta, Ga.; Department of Surgery, Emory University School of Medicine, Atlanta, Ga.; and Plastic Surgery, Skane University Hospital, Malmo, Sweden
| | - Caroline Tredway
- From Operation Smile, Virginia Beach, Va.; Plastic Surgery, Penn State Hershey, Hershey, Pa.; MGM Dental College and Hospital, Navi Mumbai, India; School of Medicine, Emory University, Atlanta, Ga.; Department of Epidemiology, Emory University School of Medicine, Atlanta, Ga.; Department of Surgery, Emory University School of Medicine, Atlanta, Ga.; and Plastic Surgery, Skane University Hospital, Malmo, Sweden
| | - Sarah M. Bernstein
- From Operation Smile, Virginia Beach, Va.; Plastic Surgery, Penn State Hershey, Hershey, Pa.; MGM Dental College and Hospital, Navi Mumbai, India; School of Medicine, Emory University, Atlanta, Ga.; Department of Epidemiology, Emory University School of Medicine, Atlanta, Ga.; Department of Surgery, Emory University School of Medicine, Atlanta, Ga.; and Plastic Surgery, Skane University Hospital, Malmo, Sweden
| | - Rachel Patzer
- From Operation Smile, Virginia Beach, Va.; Plastic Surgery, Penn State Hershey, Hershey, Pa.; MGM Dental College and Hospital, Navi Mumbai, India; School of Medicine, Emory University, Atlanta, Ga.; Department of Epidemiology, Emory University School of Medicine, Atlanta, Ga.; Department of Surgery, Emory University School of Medicine, Atlanta, Ga.; and Plastic Surgery, Skane University Hospital, Malmo, Sweden
| | - Lisa Wendby
- From Operation Smile, Virginia Beach, Va.; Plastic Surgery, Penn State Hershey, Hershey, Pa.; MGM Dental College and Hospital, Navi Mumbai, India; School of Medicine, Emory University, Atlanta, Ga.; Department of Epidemiology, Emory University School of Medicine, Atlanta, Ga.; Department of Surgery, Emory University School of Medicine, Atlanta, Ga.; and Plastic Surgery, Skane University Hospital, Malmo, Sweden
| | - Bjorn Schonmeyr
- From Operation Smile, Virginia Beach, Va.; Plastic Surgery, Penn State Hershey, Hershey, Pa.; MGM Dental College and Hospital, Navi Mumbai, India; School of Medicine, Emory University, Atlanta, Ga.; Department of Epidemiology, Emory University School of Medicine, Atlanta, Ga.; Department of Surgery, Emory University School of Medicine, Atlanta, Ga.; and Plastic Surgery, Skane University Hospital, Malmo, Sweden
| |
Collapse
|
8
|
Meltzer NE, Vaidya D, Capone RB. The cleft-columellar angle: a useful variable to describe the unilateral cleft lip-associated nasal deformity. Cleft Palate Craniofac J 2012; 50:82-7. [PMID: 22236271 DOI: 10.1597/10-176] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective : To study a method for quantification of the severity of either the unilateral cleft lip deformity or the associated cleft nasal deformity. A standard method would be useful for defining surgical outcomes. Design : Using a developed rating questionnaire and patient photographs, 26 nonexpert volunteers rated 14 children with untreated unilateral cleft lip according to the severity of their overall deformity, as well as the individual lip and nose deformities. The cleft-columellar angle was measured as defined by the intersection of a line in the parasagittal plane and a line perpendicular to the columellar base along the midcolumellar line. The association between deformity ratings and the cleft-columellar angle was modeled using mixed-model regression analysis. Setting : Tertiary care academic medical center. Results : After accounting for within-rater and within-child effects, the cleft-columellar angle explained a statistically significant portion of the variance in the rated severity for lip deformity (49%, p = .0012), nasal deformity (57%, p = .0001), and overall deformity (57%, p = .0005). Conclusions : Measurement of the cleft-columellar angle in two-dimensional digital photography is simple and correlative, capturing a substantial portion of nonexpert severity ratings of the constellation of deformities seen with the unilateral cleft lip deformity. Given its ease of application, the cleft-columellar angle is a useful variable in the description of the unilateral cleft lip deformity and may find utility across institutions as cleft surgeons seek to advance surgical care through outcomes research.
Collapse
|
10
|
Lee TH, Lee JH, Chung SW, Noh HW, Shim YW, Kim DW. A survival prediction model of hemorrhagic shock in rats using a logistic regression equation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2009; 2009:1274-1277. [PMID: 19964753 DOI: 10.1109/iembs.2009.5334251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Hemorrhagic shock is a common cause of death in emergency rooms. Since the symptoms of hemorrhagic shock occur after shock has considerably progressed, it is difficult to diagnose shock early. The purpose of this study was to improve early diagnosis of hemorrhagic shock using a survival prediction model in rats. We measured ECG, blood pressure, respiration and temperature in 45 Sprague-Dawley rats, and then obtained a logistic regression equation predicting survival rates. Area under the ROC curves was 0.99. The Hosmer-Lemeshow goodness-of-fit chi-square was 0.86 (degree of freedom=8, p=0.999). Applying the determined optimal boundary value of 0.25, the accuracy of survival prediction was 94.7%.
Collapse
Affiliation(s)
- Tak Hyung Lee
- Graduate Program in Biomedical Engineering, Yonsei University, Seoul, Korea.
| | | | | | | | | | | |
Collapse
|