Comparison of Three Methods of Rating Nasolabial Appearance in Cleft Lip and Palate

2017 ◽  
Vol 54 (4) ◽  
pp. 400-407 ◽  
Author(s):  
Sylwia A. Fudalej ◽  
Dries Desmedt ◽  
Ewald Bronkhorst ◽  
Piotr S. Fudalej

Objective To investigate which of three methods of rating nasolabial appearance—esthetic index, visual analogue scale (VAS), or numerical scale with reference photographs—is optimal. Design Experimental study. Setting Radboud University Medical Centre, The Netherlands and University of Bern, Switzerland. Subjects and Methods Cropped photographs of 60 patients with complete unilateral cleft lip and palate (mean age = 10.8 years) were used for rating. A panel of eight raters rated four components of nasolabial morphology (nasal shape, nose deviation, vermillion border, and profile view) using three methods: 5-point esthetic index, 100 mm VAS, and 0 to 200 numerical scale with reference photographs (reference scores method). Method reliability was assessed by re-evaluation of 20 images after >1 month. Intraclass correlation coefficients were calculated to evaluate consistency of each method. Results Overall reference scores method always produced more reproducible results (i.e., higher ICCs) than did VAS or the esthetic index. However, statistically significant differences were found between reference scores and esthetic index in rating nasal shape, nose deviation, and vermillion border only ( P < 0.001, <0.001, and 0.012, respectively) and between reference scores and VAS in rating nose deviation and vermillion border ( P < 0.001 and 0.017, respectively). Conclusion We recommend the use of reference photographs along with the VAS or numerical (from 0 to 200) semi-continuous scale. The esthetic index, based on a Likert-type scale, seems to produce the most variable results and, therefore, is not preferred.

2006 ◽  
Vol 43 (2) ◽  
pp. 129-137 ◽  
Author(s):  
Emeka Nkenke ◽  
Bernhard Lehner ◽  
Manuel Kramer ◽  
Gerd Haeusler ◽  
Stefanie Benz ◽  
...  

Objective To assess measurement errors of a novel technique for the three-dimensional determination of the degree of facial symmetry in patients suffering from unilateral cleft lip and palate malformations. Design Technical report, reliability study. Setting Cleft Lip and Palate Center of the University of Erlangen-Nuremberg, Erlangen, Germany. Patients The three-dimensional facial surface data of five 10-year-old unilateral cleft lip and palate patients were subjected to the analysis. Distances, angles, surface areas, and volumes were assessed twice. Main Outcome Measures Calculations were made for method error, intraclass correlation coefficient, and repeatability of the measurements of distances, angles, surface areas, and volumes. Results The method errors were less than 1 mm for distances and less than 1.5° for angles. The intraclass correlation coefficients showed values greater than .90 for all parameters. The repeatability values were comparable for cleft and noncleft sides. Conclusion The small method errors, high intraclass correlation coefficients, and comparable repeatability values for cleft and noncleft sides reveal that the new technique is appropriate for clinical use.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10631
Author(s):  
Adam Stebel ◽  
Wanda Urbanová ◽  
Irena Klimova ◽  
Andrzej Brudnicki ◽  
Ivana Dubovska ◽  
...  

Background There is a multitude of protocols of treatment of cleft lip and palate (CLP) worldwide differing in number of operations, surgical techniques, and timings of surgeries. Despite, facial appearance in subjects with CLP is rarely ideal and residual stigmata are easy to notice in many patients irrespective of the protocol. The prospective controlled investigations are optimal for comparing effectiveness of treatment protocols. Because prospective studies are very challenging to perform in CLP field, it is reasonable to retrospectively assess different surgical protocols to identify the promising ones and then to test them in a prospective way. Methods Our objective was to assess the nasolabial appearance in a preadolescent Slavic population with unilateral cleft lip and palate (UCLP) by using the 0–200 numeric scale with reference photographs. Patients treated in Warsaw, Poland (n = 32), Prague, Czech Republic (n = 26) and Bratislava, Slovakia (n = 17) were included in this retrospective study. Each cleft center used a unique surgical protocol. Two panels of professional raters (n = 7) and laypeople (n = 10) scored blindly the nasolabial esthetics on cropped frontal and profile images with cropped reference photograph present on the same slide. Intra- and inter-rater agreement was assessed with Cronbach’s alpha, intraclass correlation coefficients, t-tests, and Bland–Altman plots. Inter-group differences were evaluated with one-way ANOVA and regression analysis. Results The agreement within and between raters was acceptable. We found that patients treated in Warsaw, Prague, and Bratislava showed comparable nasolabial appearance on frontal and profile photographs when judged by both professional raters (p > 0.05) and laypeople (p > 0.05). Regression analysis did not identify influence of gender, group (i.e., Warsaw, Prague, and Bratislava), age at lip repair, surgeon, and age at photographic assessment on esthetic outcome (p > 0.05). Conclusion This study showed that none of the surgical protocols showed superiority to produce good nasolabial appearance.


2019 ◽  
Vol 57 (1) ◽  
pp. 21-28
Author(s):  
Tara V. N. Lee ◽  
Anthony J. Ireland ◽  
Nikki E. Atack ◽  
Scott A. Deacon ◽  
Timothy E. M. Jones ◽  
...  

Objective: To determine whether a relationship exists between the aesthetic scores given to photographic records of the nasolabial region of patients with repaired unilateral cleft lip and palate (UCLP) and the 5-Year Olds’ Index scores of study models for the same participants. Design: Retrospective study. Setting: University of Bristol Dental Hospital, United Kingdom. Participants: Patients with nonsyndromic UCLP previously enrolled in the Cleft Care UK (CCUK) Study. Methods: The CCUK participants, who had both study models and photographs (frontal and worm’s eye view), were identified and their records retrieved. These were rated by 2 consultants and 2 senior registrars in orthodontics. The 5-Year Olds’ Index was used to score the study models, and at a separate sitting, a 5-point Likert scale was used to score the cropped frontal and worm’s eye view photographs of the same children. The results were analyzed using intraclass correlation coefficients and Cohen κ. Main Outcome Measures: Correlation between the aesthetic scores of the photographic views and the concordant 5-Year Olds’ Index scores of the study models. Results: The intraclass correlation coefficient scores showed very poor agreement between the photographic views and their concordant study models. The level of inter- and intra-rater reliability was strongest when scoring the study models. Conclusions: There was no agreement between the scores given to various photographic views and their corresponding study models. Scoring the study models using the 5-Year Olds’ Index was the most reliable outcome measure for this age-group.


2002 ◽  
Vol 22 (1_suppl) ◽  
pp. 102-114 ◽  
Author(s):  
Marie-Josée Dion ◽  
Pierre Tousignant ◽  
Jean Bourbeau ◽  
Dick Menzies ◽  
Kevin Schwartzman

Health preferences have not previously been investigated among patients with tuberculous infection or disease. The authors assessed the reliability of visual analogue scale (VAS) and standard gamble (SG) measurements in this patient population. Participants were interviewed 3 times in English or French, at weekly intervals. They evaluated their own health status, as well as 3 marker health states, derived by consensus among tuberculosis (TB) practitioners. For the VAS, health states were assigned a duration of 6 months, whereas for the SG, the duration was 10 years. One hundred eighty-six potentially eligible individuals were identified from the TB clinic database of the Montreal Chest Institute. One hundred twelve (60%) were successfully located; of these, 106 were confirmed eligible. Sixty-seven (63%) agreed to participate, and 50 completed all study measurements (25 treated for latent TB, 17 treated for active TB, and 8 with previous active TB); 38 out of 50 were foreign-born. Intraclass correlation coefficients for the marker states were 0.57 to 0.81 for the VAS, and 0.75 to 0.87 for the SG. For respondents’ own health, the coefficients were 0.60 and 0.87, respectively. Median VAS scores for respondents’ own health were 85.0 to 88.0 for the 3 interviews, whereas the median utility score was 97.5 for all 3. Administration of the visual analogue scale and standard gamble instruments appeared reliable in a selected group of tuberculosis patients. Major barriers to recruitment were language and mobility in this largely foreign-born population.


2018 ◽  
Vol 56 (2) ◽  
pp. 248-256 ◽  
Author(s):  
Tarun K. Mittal ◽  
Anthony J. Ireland ◽  
Nikki E. Atack ◽  
Sam D. Leary ◽  
Joyce I. Russell ◽  
...  

Objective: Can we reliably discriminate severity within the existing categories of the 5-Year-Olds’ Index? Design: Retrospective method comparison and development study. Setting: School of Oral and Dental Science, University of Bristol. Methods: Dental study models of 5-year-olds with unilateral cleft lip and palate (UCLP) were collected from the archives of 2 national cleft surveys (n = 351). One hundred randomly selected models were ranked to construct the modified 5-Year-Olds’ Index and also scored using a visual analogue scale (VAS). Reliability testing was performed on 51 study models. Visual analogue scale scores were used to aid statistical analysis and investigate the reliability of a VAS for outcome measurement. The modified 5-Year-Olds’ Index was then applied to 198 study models of 5-year-olds with UCLP. Results: The modified 5-Year-Olds’ Index showed excellent intra and interexaminer agreement (intraclass correlation > 0.94) and good discrimination of severity. When applied to the Cleft Care UK participants (n = 198), the modified 5-Year-Olds’ Index showed good discrimination of severity within the better categories (groups 1-3) of the 5-Year-Olds’ Index. Visual analogue Scale scores resulted in unacceptable variation between measurements. Conclusions: The new modified 5-Year-Olds’ Index is a reliable method of assessing outcomes at 5 years of age and showed improved discriminatory power between the “better” outcome categories than the original 5-Year-Olds’ Index. A VAS was found to be unsuitable for assessing outcome at 5 years of age for children with UCLP.


1991 ◽  
Vol 34 (5) ◽  
pp. 989-999 ◽  
Author(s):  
Stephanie Shaw ◽  
Truman E. Coggins

This study examines whether observers reliably categorize selected speech production behaviors in hearing-impaired children. A group of experienced speech-language pathologists was trained to score the elicited imitations of 5 profoundly and 5 severely hearing-impaired subjects using the Phonetic Level Evaluation (Ling, 1976). Interrater reliability was calculated using intraclass correlation coefficients. Overall, the magnitude of the coefficients was found to be considerably below what would be accepted in published behavioral research. Failure to obtain acceptably high levels of reliability suggests that the Phonetic Level Evaluation may not yet be an accurate and objective speech assessment measure for hearing-impaired children.


Author(s):  
Marcos A Soriano ◽  
G Gregory Haff ◽  
Paul Comfort ◽  
Francisco J Amaro-Gahete ◽  
Antonio Torres-González ◽  
...  

The aims of this study were to (I) determine the differences and relationship between the overhead press and split jerk performance in athletes involved in weightlifting training, and (II) explore the magnitude of these differences in one-repetition maximum (1RM) performances between sexes. Sixty-one men (age: 30.4 ± 6.7 years; height: 1.8 ± 0.5 m; body mass 82.5 ± 8.5 kg; weightlifting training experience: 3.7 ± 3.5 yrs) and 21 women (age: 29.5 ± 5.2 yrs; height: 1.7 ± 0.5 m; body mass: 62.6 ± 5.7 kg; weightlifting training experience: 3.0 ± 1.5 yrs) participated. The 1RM performance of the overhead press and split jerk were assessed for all participants, with the overhead press assessed on two occasions to determine between-session reliability. The intraclass correlation coefficients (ICC) and 95% confidence intervals showed a high reliability for the overhead press ICC = 0.98 (0.97 – 0.99). A very strong correlation and significant differences were found between the overhead press and split jerk 1RM performances for all participants (r = 0.90 [0.93 – 0.85], 60.2 ± 18.3 kg, 95.7 ± 29.3 kg, p ≤ 0.001). Men demonstrated stronger correlations between the overhead press and split jerk 1RM performances (r = 0.83 [0.73-0.90], p ≤ 0.001) compared with women (r = 0.56 [0.17-0.80], p = 0.008). These results provide evidence that 1RM performance of the overhead press and split jerk performance are highly related, highlighting the importance of upper-limb strength in the split jerk maximum performance.


Dysphagia ◽  
2021 ◽  
Author(s):  
Sofie Albinsson ◽  
Lisa Tuomi ◽  
Christine Wennerås ◽  
Helen Larsson

AbstractThe lack of a Swedish patient-reported outcome instrument for eosinophilic esophagitis (EoE) has limited the assessment of the disease. The aims of the study were to translate and validate the Eosinophilic Esophagitis Activity Index (EEsAI) to Swedish and to assess the symptom severity of patients with EoE compared to a nondysphagia control group. The EEsAI was translated and adapted to a Swedish cultural context (S-EEsAI) based on international guidelines. The S-EEsAI was validated using adult Swedish patients with EoE (n = 97) and an age- and sex-matched nondysphagia control group (n = 97). All participants completed the S-EEsAI, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Oesophageal Module 18 (EORTC QLQ-OES18), and supplementary questions regarding feasibility and demographics. Reliability and validity of the S-EEsAI were evaluated by Cronbach’s alpha and Spearman correlation coefficients between the domains of the S-EEsAI and the EORTC QLQ-OES18. A test–retest analysis of 29 patients was evaluated through intraclass correlation coefficients. The S-EEsAI had sufficient reliability with Cronbach’s alpha values of 0.83 and 0.85 for the “visual dysphagia question” and the “avoidance, modification and slow eating score” domains, respectively. The test–retest reliability was sufficient, with good to excellent intraclass correlation coefficients (0.60–0.89). The S-EEsAI domains showed moderate correlation to 6/10 EORTC QLQ-OES18 domains, indicating adequate validity. The patient S-EEsAI results differed significantly from those of the nondysphagia controls (p < 0.001). The S-EEsAI appears to be a valid and reliable instrument for monitoring adult patients with EoE in Sweden.


Author(s):  
Jens Sörensen ◽  
Jonny Nordström ◽  
Tomasz Baron ◽  
Stellan Mörner ◽  
Sven-Olof Granstam ◽  
...  

Abstract Aim To develop a method for diagnosing left ventricular (LV) hypertrophy from cardiac perfusion 15O-water positron emission tomography (PET). Methods We retrospectively pooled data from 139 subjects in four research cohorts. LV remodeling patterns ranged from normal to severe eccentric and concentric hypertrophy. 15O-water PET scans (n = 197) were performed with three different PET devices. A low-end scanner (66 scans) was used for method development, and remaining scans with newer devices for a blinded evaluation. Dynamic data were converted into parametric images of perfusable tissue fraction for semi-automatic delineation of the LV wall and calculation of LV mass (LVM) and septal wall thickness (WT). LVM and WT from PET were compared to cardiac magnetic resonance (CMR, n = 47) and WT to 2D-echocardiography (2DE, n = 36). PET accuracy was tested using linear regression, Bland–Altman plots, and ROC curves. Observer reproducibility were evaluated using intraclass correlation coefficients. Results High correlations were found in the blinded analyses (r ≥ 0.87, P < 0.0001 for all). AUC for detecting increased LVM and WT (> 12 mm and > 15 mm) was ≥ 0.95 (P < 0.0001 for all). Reproducibility was excellent (ICC ≥ 0.93, P < 0.0001). Conclusion 15O-water PET might detect LV hypertrophy with high accuracy and precision.


Author(s):  
Igor Junio de Oliveira Custódio ◽  
Gibson Moreira Praça ◽  
Leandro Vinhas de Paula ◽  
Sarah da Glória Teles Bredt ◽  
Fabio Yuzo Nakamura ◽  
...  

This study aimed to analyze the intersession reliability of global positioning system (GPS-based) distances and accelerometer-based (acceleration) variables in small-sided soccer games (SSG) with and without the offside rule, as well as compare variables between the tasks. Twenty-four high-level U-17 soccer athletes played 3 versus 3 (plus goalkeepers) SSG in two formats (with and without the offside rule). SSG were performed on eight consecutive weeks (4 weeks for each group), twice a week. The physical demands were recorded using a GPS with an embedded triaxial accelerometer. GPS-based variables (total distance, average speed, and distances covered at different speeds) and accelerometer-based variables (Player Load™, root mean square of the acceleration recorded in each movement axis, and the root mean square of resultant acceleration) were calculated. Results showed that the inclusion of the offside rule reduced the total distance covered (large effect) and the distances covered at moderate speed zones (7–12.9 km/h – moderate effect; 13–17.9 km/h – large effect). In both SSG formats, GPS-based variables presented good to excellent reliability (intraclass correlation coefficients – ICC > 0.62) and accelerometer-based variables presented excellent reliability (ICC values > 0.89). Based on the results of this study, the offside rule decreases the physical demand of 3 versus 3 SSG and the physical demands required in these SSG present high intersession reliability.


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