A Physician-Centered Craniofacial Asymmetry Index for the Severity of Plagiocephaly: A Comparative Study of Assessment Methods.

Autor:	Lee CH; From the Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan., Lin TH; School of Medicine, Chang Gung University, Taoyuan City, Taiwan., Chen SH; Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan., Chen MT; From the Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan., Chen PR; Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan., Shih AJ; Mechanical Engineering, Biomedical Engineering, University of Michigan, Ann Arbor, MI., Lee CC; From the Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan., Chou PY; Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Jazyk:	angličtina
Zdroj:	Annals of plastic surgery [Ann Plast Surg] 2024 Dec 05. Date of Electronic Publication: 2024 Dec 05.
DOI:	10.1097/SAP.0000000000004179
Abstrakt:	Background: Plagiocephaly, wherein infants' head exhibits a diagonal asymmetry, is currently diagnosed based on physicians' subjective judgment. Discrepancies between physician and parent perspectives may result in dissatisfaction with treatment outcomes. This problem highlights the need for an objective assessment system aligning with physician-made clinical diagnoses. Methods: Infant heads were modeled using 3-dimensional scanning techniques. We developed a craniofacial asymmetric index (CAI) based on 10 height planes of heads with varying weight. CAI and traditional craniofacial vault asymmetry index (CVAI) of 10 infants undergoing helmet therapy were compared with 11 craniofacial surgeons' judgment. The Pearson correlation coefficient and Bland-Altman plot were used to determine the correlations and agreement between physicians' judgment and the aforementioned assessment methods. The adjusted intraclass correlation coefficient was calculated to evaluate the reliability of between-physician agreement. Results: All 10 infants were divided into the following 3 severity groups: severe, moderate, and mild groups based on craniofacial surgeons' judgment. Notably in CAI, front/back halves of skull and multiangular weighting factors were evaluated. The evaluation revealed perfect alignment in severity classification between the CAI and physicians' judgment, whereas both the CVAI score and MATLAB analysis show varying degrees of difference, 6 and 4 distinct results, respectively. Coefficients of the correlations of physician-assigned scores with the MATLAB analysis, CVAI score, and CAI score were 0.500, 0.833, and 1.000, respectively. Furthermore, Bland-Altman plots revealed the best agreement between CAI and physician-assigned scores. Conclusions: CAI closely aligns with the subjective judgment of craniofacial surgeons' assessing the severity of plagiocephaly in infants. Competing Interests: Conflicts of interest and sources of funding: none declared. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu